en Anesthesiology Anesthesiology Original Article Original Article <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="color:#0033ff;"><strong><em>Background</em></strong><em>:</em></span> Pediatric patients feel significant fear and anxiety when undergoing surgeries. The ideal drug and its administration route have not been found yet. The aim of this study was to compare the efficacy and safety of intranasal (IN) ketamine and midazolam as premedication in children.<br> <span style="color:#0033ff;"><strong><em>Methods</em></strong><em>:</em></span> We studied 71 eligible pediatric patients undergoing elective urologic surgeries, aged 2 to 6 years. The degree of sedation and separation scores was compared between the two groups. Additionally, hemodynamic parameters, before premedication, after induction of anesthesia, and during surgery were documented and compared between two groups. Postoperatively, any side effect was recorded as well.<br> <span style="color:#0033ff;"><strong><em>Results</em></strong><em>:</em></span> Finally, the data from 71 children were analyzed.&nbsp; Recovery time was significantly longer in group K (ketamine) compared to group M (midazolam); 27.86<span dir="RTL">&plusmn;</span>4.42 vs 38.19<span dir="RTL">&plusmn;</span> 6.67 minutes respectively (P=0.01). No significant difference was observed in terms of sedation score between two groups of K & M; 3.29<span dir="RTL">&plusmn;</span>0.78 vs 3 <span dir="RTL">&plusmn;</span>0.71 respectively (P=0.17), and not regarding separation score; 2.51<span dir="RTL">&plusmn;</span>0.61 & 2.31 <span dir="RTL">&plusmn;</span>0.52 respectively (P=0.01). Vital signs were kept within the physiological limits in both groups with no marked fluctuations.<br> <span style="color:#0033ff;"><strong><em>Conclusion</em></strong><em>:</em></span> To produce sedation in young children, both midazolam and ketamine were effective and safe by IN route.</span></span> Ketamine, Midazolam, Intranasal, Pediatrics, Sedation 539 543 http://caspjim.com/browse.php?a_code=A-10-1969-1&slc_lang=en&sid=1 Hossein Khoshrang hkhoshrang@yahoo.com 100319475328460032119 100319475328460032119 No Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences , Rasht, Iran Cyrus Emir Alavi Cyrusemiralavi@yahoo.com 100319475328460032120 100319475328460032120 No Department Razi Clinical Research Development Center. Guilan University of Medical Sciences, Rasht, Iran. Siamak Rimaz smkrimaz@yahoo.com 100319475328460032121 100319475328460032121 No Anesthesiology Research Center, Department of Anesthesiology ,Alzahra Hospital, Guilan University of Medical Sciences , Rasht, Iran. Ali Mirmansouri mirmansoori.ali@gmail.com 100319475328460032122 100319475328460032122 No Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences, Rasht, Iran Farnoush Farzi Farnoushfarzi1374@gmail.com 100319475328460032123 100319475328460032123 No Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences, Rasht, Iran Gelareh Biazar gelarehbiazar1386@gmail.com 100319475328460032124 100319475328460032124 Yes Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences, Rasht, Iran Zahra Atrkarroushan atrkarroushan@gmail.com 100319475328460032125 100319475328460032125 No Department of Statistic, Guilan University of Medical Sciences, Rasht, Iran Nazanin Sabet Khadem sabet_nazanin@yahoo.com 100319475328460032126 100319475328460032126 No Student of Medicine, Student Research Committee, Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences, Rasht, Iran