Efficacy of intranasal dexmedetomidine in combination with ketamine as premedication and sedation in pediatric patients: A systematic review and meta-analysis
- Author:
Cristina Marides L. Quijano
;
Kryzia June B. Balneg
- Publication Type:Journal Article
- Keywords:
Intranasal;
Pediatric
- MeSH:
Dexmedetomidine;
Ketamine;
Premedication
- From:
The Philippine Children’s Medical Center Journal
2024;20(1):84-102
- CountryPhilippines
- Language:English
-
Abstract:
Objective:To compare the efficacy and safety of the combination of Dexmedetomidine (Dex)
and Ketamine (Ket) administered via the intranasal (IN) route on sedation of children aged 0 to 12
years old prior to elective surgery or procedural sedation as compared to Intranasal
Dexmedetomidine.
Methods:Relevant studies were identified after a literature search on electronic databases as
PubMed, Cochrane Library, Google Scholar and Science Direct. Meta-analyses of mean differences
were performed to examine differences in sedation onset and recovery times between IN Dex-Ket
and IN Dex. Meta-analyses of proportions were performed to estimate the incidence of sedation
success, satisfactory sedation at parental separation and mask induction, and incidence of adverse
events. Review Manager 5.4.1 was used for statistical analysis.
Results:Six articles (388 patients) were included. The overall incidence of sedation success was
higher among children premedicated with IN Dex-Ket (RR = 1.05; 95%CI = 0.97,1.13; P = 0.27, I2
= 20%) however was not statistically significant. Children given IN Dex-Ket had faster sedation
onset time (WMD = -7.17; 95%CI = -12.44, -1.89; P=0.008) with greater incidence of satisfactory
sedation at mask induction (RR = 0.71; 95%CI = 0.53, 0.94; P = 0.02). There was no significant
difference as to recovery time and incidence of adverse events among the groups.
Conclusion:Premedication with IN Dex-Ket is as safe as IN Dex but of better efficacy as
evidenced by faster sedation onset time and smoother inhalational induction without increasing
clinically relevant adverse events.
- Full text:2024062614565558235Efficacy of intranasal Dexmedetomidine.pdf
