To evaluate the depth of sedation, as well as onset, and recovery times, satisfaction of sedation , adverse events associated with Atomized Midazolam & Fentanyl and Dexmedetomidine during procedural sedation in a diverse population spanning from 2 to 60 years old at these three prominent Omani healthcare facilities.

Inclusion Criteria:

• inclusion criteria:

  1. Patients aged 2 to 60 years.
  2. Patients undergoing EM procedures requiring sedation.

Exclusion criteria:

1. Patients with contraindications to any of the sedation agents being studied.
2. Patients with a history of adverse reactions or allergies to the study medications.
3. Drug interactions: Patients taking certain medications that may interact adversely with the study medications.
4. Drug Abuser
5. Pregnancy and breastfeeding
6. Patients with significant cardiovascular or respiratory compromise.
7. Patients with nasal disorder (nasal trauma, epistaxis)
8. Patients unable to provide informed consent or those with cognitive impairment.
9. Patients who are < 2 year of age or > 60 year of age.
10. Patient underwent procedure sedation for imaging