Abstract Introduction: Preoperative anxiety in the pediatric population leads to tachycardia, agitation, excessive crying, and postoperative emergence delirium. The intranasal route of premedication is effective, easy, has high bioavailability, and a rapid onset due to the highly vascularized nasal mucosa. This study compares the efficacy of intranasal ketamine with dexmedetomidine versus intranasal ketamine with midazolam as premedication for sedation in children. Materials and Methods: This randomized, double-blind study included 56 children aged between 3 and 8 years undergoing elective infraumbilical surgeries. Patients were randomized into Group “KD” – intranasal ketamine 1 mg/kg with dexmedetomidine 1 μg/kg and Group “KM” – intranasal ketamine 1 mg/kg with midazolam 0.2 mg/kg. The drugs were given 30 min before the induction of anesthesia. The level of sedation was assessed using the Modified Observer’s Assessment of Alertness/Sedation Score, Parental Separation Score, Parent Satisfaction Score, Mask Acceptance Score, and Postoperative Emergence Score. Results: The Mean Sedation Score, Postoperative Sedation Score, Parental Separation Score, Mask Acceptance Score, and Parent Satisfaction Score between the two groups were found to be statistically significant between both groups ( P 0.05). Two patients in Group KD had tachycardia, and one patient from each group developed hypotension in the postoperative area. Conclusion: A combination of intranasal ketamine (1 mg/kg) with midazolam (0.2 mg/kg) is better than intranasal ketamine (1 mg/kg) with dexmedetomidine (1 mcg/kg) in terms of premedication, mask acceptance, and separation anxiety.
Kamal et al. (Fri,) studied this question.
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