Background & Aims: Most of the preschool children suffer from severe preoperative anxiety of parental separation; it may to predispose them to emergence delirium, behavioural changes and long lasting psychological trauma post operatively. Midazoalm has emerged as an ideal anxiolytic to remove fear and anxiety in children, it can be administered by various routes, oral and intranasal routes are preferred for pediatric sedation. So we designed current study to find out the efficacy of midazolam intranasally. Material & Methods: Fifty paediatric patients of 2-5 years of age belonging to ASA I & II, scheduled for elective surgery under general anaesthesia were selected for this prospective, randomized double blinded observational study. Patients were divided in two groups, Group M received midazolam 0.2 mg/kg intranasally and Group C received normal saline. Outcomes measured include the haemodynamic parameters, level of sedation, emotional reaction, and response to parental separation, acceptance of intravenous cannulation and facemask application and adverse effects, if any. Results: A statistically significant change in the level of sedation was found at10 min in group M as compared to control group. Parental separation was significantly easier in midazolam groups. The acceptance for intravenous cannulation and face mask was also found to be significantly better in midazolam groups. No significant difference was observed in incidence of adverse effects among both the groups. Conclusion: we conclude that 0.2 mgkg-1 intranasal midazolam is an effective premedication for producing anxiolysis and sedation in paediatric patients without any untoward adverse effects
