Sathyamoorthy M, et al. - In this prospective, single-blind randomized control trial performed at a tertiary care center, researchers investigated whether intranasal dexmedetomidine is a superior pre-medication to oral midazolam in older, difficult children. They randomly allocated 75 children (age >5 years and weight >20 kg) who required general anesthesia for dental procedures to receive pre-medication with either oral midazolam at a dose of 0.5 mg/kg (max 15 mg) or intranasal dexmedetomidine at a dose of 2 mcg/kg (max 100 mcg). They evaluated patients' level of sedation when separated from their parents as the primary outcome, as well as the level of anxiolysis as the secondary outcome. They found that a higher success rate in sedation and parental separation was achieved with intranasal dexmedetomidine vs oral midazolam, in older, difficult children.