A prospective study conducted at HN Reliance Hospital suggests that a modified intranasal spray may help reduce anxiety and pain in adults undergoing certain medical procedures. The research, carried out between July 2023 and June 2024, was recently published in the International Journal of Clinical Anesthesia and Research.
Study Design and Patient Groups
The study enrolled over 300 adults scheduled for gastrointestinal endoscopy. Researchers divided participants into two groups.
The control group received standard intravenous (IV) sedation. In contrast, the test group received pre-operative medication through a modified intranasal spray containing ketamine, midazolam, and lignocaine—drugs commonly used by anaesthetists to induce sedation and relieve pain.
Improved Comfort and Reduced Anxiety
According to lead author Dr. Misha Mehta, the intranasal drug delivery system achieved better pain control, improved mobility, and lower post-operative anxiety compared to the IV sedation group.
Senior author and anaesthesiologist Dr. Hemant Mehta explained that many patients experience significant anxiety upon entering the operating theatre. They often feel distressed when separated from family members and intimidated by surgical instruments.
He noted that the spray induces a trance-like state, allowing patients to remain calm while still responding when spoken to. Consequently, patients appeared more comfortable before and after the procedure.
Aligning with Advances in Anaesthesia
Recent developments in anaesthesia support such innovations. An article published in January 2025 in Anesthesiology and Perioperative Science highlighted how artificial intelligence is advancing automated anaesthesia systems, thereby improving precision and efficiency in complex surgical environments.
In this context, the intranasal spray represents a step toward more patient-friendly and adaptable sedation techniques.
Additional Benefits Observed
As reported by TOI, the medical team administered the spray before surgery and repeated doses at four-hour intervals when required. Doctors observed that many patients fear IV medications; however, the nasal spray reduced this anxiety.
Moreover, patients in the spray group reported fewer post-operative symptoms such as nausea and vomiting, suggesting improved overall tolerance.
Experts Call for Cautious Adoption
Despite encouraging findings, experts urge careful selection of patients. Dr. Ashish Mali, Additional Professor at BYL Nair Hospital, stated that while intranasal sprays may effectively reduce anxiety, they may not provide sufficient sedation for all types of surgeries.
He emphasised that sedation dosage depends on the complexity of the procedure. In major surgeries, anaesthesiologists prefer IV administration because it allows rapid intervention if complications such as sudden blood pressure drops occur.
Furthermore, he noted that nasal sprays may not suit all patients. However, they could prove useful in dentistry, paediatric care, and non-invasive procedures such as prolonged MRI scans or endoscopy.
Toward More Patient-Centric Sedation
Overall, the study highlights the potential of intranasal drug delivery as a less intimidating and more comfortable alternative to traditional IV sedation in selected procedures. While it may not replace conventional methods entirely, it opens new avenues for patient-centric anaesthesia practices.