Efficacy of Intranasal Dexmedetomidine as a Preoperative Anxiolytic in Children: A Systematic Review
Preoperative anxiety is a common problem in pediatric patients that can have many negative effects; oral premedications (eg, midazolam) are often used to reduce anxiety and improve compliance. Dexmedetomidine (DEX) is an alpha-2 receptor agonist that can be given intranasally to children as a premedication and may be useful as an anxiolytic. In this systematic review of the PubMed, CINAHL, Ovid, and Cochrane Library databases, the efficacy of intranasal dexmedetomidine (IN DEX) was compared with that of oral midazolam for relieving preoperative anxiety among pediatric surgical patients. Three trials were assessed: 2 of these trials concluded that IN DEX was a superior anxiolytic for use in children; the third showed that there was no significant difference. More rigorous research that includes a larger sample size and an objective measurement tool is needed before drawing conclusions.
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