Intranasal dexmedetomidine versus intranasal midazolam as sole sedative agents for pelviabdominal magnetic resonance imaging in pediatrics: A randomized double-blind trial

Background: The diagnostic effectiveness of magnetic resonance imaging (MRI) resulted in its growing usage among cases of all ages. Nevertheless, children having MRIs are frequently sedated due to the magnetic field's extremely loud decibel level and to avoid motion artefacts. This research aimed to compare the efficacy and safety of intranasal dexmedetomidine and midazolam in pediatric MRI patients. Materials and Methods: This double-blind, randomized clinical trial involved 60 cases aged 2-8 years, both sexes getting elective MRI. Sixty children were randomly allocated into two equal groups, subjects in group D were sedated with 2 μg/kg intranasal dexmedetomidine, whereas group M were sedated with 0.3 mg/kg intranasal midazolam. Successful sedation was considered when the Modified Observer Assessment of Alertness/Sedation Scale < 4. Results: The 1st and 2nd dose success rates were significantly higher in group D (80% and 90%) as opposed to group M (46.67% and 63.33%) (P = 0.015 and 0.032, respectively). Sedation onset was significantly faster in group D compared to group M (P = 0.037). Sedation time was significantly prolonged in group D than group M (P = 0.044). MRI satisfaction of operator was significantly higher in group D compared to group M (P = 0.022). Conclusion: Intranasal dexmedetomidine provided higher incidence of successful sedation and operator satisfaction with quicker onset and prolonged period of sedation and less adverse events than intranasal midazolam in pediatrics undergoing pelviabdominal MRI.