Comparison Between Dexmeditomidine, Midazolam and Ketamine as a Sedative to Help Cannula Insertion in Pediatric Patient

• Status: Completed
• Trial end date: 2021-02-15
• Target enrollment: 0
• Participant gender: All

Summary

Background and Objectives: Surgery and hospitalization present a very stressful period for children and their parents. The induction of anesthesia and cannula insertion may be the only bad experience a child can remember during his procedure. Pediatric intravenous cannulation is technically difficult and moreover may cause psychological problems. Sedative Premedication has a great role in pediatric anesthesia to overcome fear and anxiety and to facilitate easy separation from their parents. Intranasal approach is safe and painless and well tolerated by children in addition to a comparable onset of action with the intravenous approach. Midazolam, dexmedetomidine and ketamine have proved their effectiveness as a sedative premedication. The objective of the current study was to compare the effectiveness of administration of intranasal midazolam, dexmedetomidine and ketamine as sedatives to facilitate and decrease the discomfort of intravenous cannulation before surgery in children undergoing various surgical procedures. Methods: the patients agreed to participate in the research were classified into 3 groups. Dexmedetomidine, Midazolam and Ketamine group; each group received the intranasal drug 30 min before the procedure. Pulse, MAP, oxygen saturation and sedation score (MOAA/S) baseline and every 10 min. Easiness of venipuncture, parental separation and any complication encountered were recorded.

• Phase: Phase 2/Phase 3
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: Ain Shams University
• Treatments: Dexmedetomidine; Ketamine; Midazolam

Criteria

Inclusion Criteria: all the following must be included

• child aged between 2-9 years scheduled for minor elective surgical procedures (last 1-2 hours) at pediatric surgery department.

• Patients were ASA I or II.

• within normal range of weight.

• refusing venous cannulation

Exclusion Criteria: any of the following

• parents' refusal

• with nasal deformity or pathology

• any known case of allergy to the study drugs

• obese patients

• suspected difficult airway or venous cannulation.

• maxillofacial malformations

• gastroesophageal reflux

• patients with renal, liver, endocrine or cardiac pathology

• patients with increased intracranial or intraocular pressure

• patients with sleep apnea

• any patient with a preexisting cannula or accepting cannula insertion