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Abstract：
UNASSIGNED: The management of preoperative anxiety in pediatric patients, as well as its implications, has remained challenging for anesthesiologists. In this study, we compared the safety and efficacy of intranasal dexmedetomidine, midazolam, and ketamine as surgical premedication in children.
UNASSIGNED: This double-blinded randomized clinical trial was conducted at two tertiary hospitals in January 2014, on 90 children aged between 2-7 years old. The participants\' American Society of Anesthesiologists (ASA) physical status was I or II, and they were scheduled for elective unilateral inguinal herniorrhaphy. Using the block randomization method, the patients were randomly assigned to three groups, each receiving intranasal dexmedetomidine (2 µg/Kg), midazolam (0.2 mg/Kg), and ketamine (8 mg/Kg) 60 min before induction of anesthesia. Anxiety and sedation state were evaluated before drug administration, and then every 10 min for the next 50 min. Parental separation anxiety, mask acceptance, postoperative agitation, pain, nausea, and vomiting were also recorded and compared between these groups. All the statistical analyses were performed using SPSS software (version 21.0). P<0.05 was considered statistically significant.
UNASSIGNED: Ketamine indicated the strongest sedative effect 10, 20, and 30 min after administration of premedication (P<0.001, P=0.03, P=0.01, respectively). However, dexmedetomidine was more effective than other drugs after 40 and 50 min (P<0.001). Other variables indicated no statistically significant difference.
UNASSIGNED: In case of emergencies, intranasal ketamine, with the shortest time of action, could be administered. Intranasal dexmedetomidine, which was revealed to be the most potent drug in this study, could be administrated 40-50 min before elective pediatric surgeries.Trial registration number: IRCT2013081614372N1.
UNASSIGNED: This double-blinded randomized clinical trial was conducted at two tertiary hospitals in January 2014, on 90 children aged between 2-7 years old. The participants\' American Society of Anesthesiologists (ASA) physical status was I or II, and they were scheduled for elective unilateral inguinal herniorrhaphy. Using the block randomization method, the patients were randomly assigned to three groups, each receiving intranasal dexmedetomidine (2 µg/Kg), midazolam (0.2 mg/Kg), and ketamine (8 mg/Kg) 60 min before induction of anesthesia. Anxiety and sedation state were evaluated before drug administration, and then every 10 min for the next 50 min. Parental separation anxiety, mask acceptance, postoperative agitation, pain, nausea, and vomiting were also recorded and compared between these groups. All the statistical analyses were performed using SPSS software (version 21.0). P<0.05 was considered statistically significant.
UNASSIGNED: Ketamine indicated the strongest sedative effect 10, 20, and 30 min after administration of premedication (P<0.001, P=0.03, P=0.01, respectively). However, dexmedetomidine was more effective than other drugs after 40 and 50 min (P<0.001). Other variables indicated no statistically significant difference.
UNASSIGNED: In case of emergencies, intranasal ketamine, with the shortest time of action, could be administered. Intranasal dexmedetomidine, which was revealed to be the most potent drug in this study, could be administrated 40-50 min before elective pediatric surgeries.Trial registration number: IRCT2013081614372N1.
摘要：
■儿科患者术前焦虑的管理，以及它的含义，对麻醉师来说仍然具有挑战性。在这项研究中,我们比较了鼻腔右美托咪定的安全性和有效性，咪达唑仑,氯胺酮作为儿童手术前用药。
■这项双盲随机临床试验于2014年1月在两家三级医院进行，对象是90名2-7岁的儿童。参与者\'美国麻醉医师协会（ASA）的身体状况是I或II，他们被安排进行选择性单侧腹股沟疝修补术。使用块随机化方法，患者被随机分为三组，每个人鼻内接受右美托咪定（2µg/Kg），咪达唑仑（0.2mg/Kg），麻醉诱导前60分钟和氯胺酮（8mg/Kg）。给药前进行焦虑、镇静状态评估,然后在接下来的50分钟内每10分钟一次。父母分离焦虑，面罩验收,术后躁动,疼痛,恶心,并记录和比较这些组之间的呕吐。所有统计分析均使用SPSS软件（21.0版）进行。P<0.05被认为具有统计学意义。
■氯胺酮显示给药后10、20和30分钟的镇静作用最强（分别为P<0.001，P=0.03，P=0.01）。然而,右美托咪定在40和50min后比其他药物更有效(P<0.001).其他变量无统计学意义差异。
■在紧急情况下，鼻内氯胺酮,用最短的时间行动，可以管理。鼻内右美托咪定，它被认为是这项研究中最有效的药物，可以在择期儿科手术前40-50分钟给药。试验注册号：IRCT2013081614372N1。
■这项双盲随机临床试验于2014年1月在两家三级医院进行，对象是90名2-7岁的儿童。参与者\'美国麻醉医师协会（ASA）的身体状况是I或II，他们被安排进行选择性单侧腹股沟疝修补术。使用块随机化方法，患者被随机分为三组，每个人鼻内接受右美托咪定（2µg/Kg），咪达唑仑（0.2mg/Kg），麻醉诱导前60分钟和氯胺酮（8mg/Kg）。给药前进行焦虑、镇静状态评估,然后在接下来的50分钟内每10分钟一次。父母分离焦虑，面罩验收,术后躁动,疼痛,恶心,并记录和比较这些组之间的呕吐。所有统计分析均使用SPSS软件（21.0版）进行。P<0.05被认为具有统计学意义。
■氯胺酮显示给药后10、20和30分钟的镇静作用最强（分别为P<0.001，P=0.03，P=0.01）。然而,右美托咪定在40和50min后比其他药物更有效(P<0.001).其他变量无统计学意义差异。
■在紧急情况下，鼻内氯胺酮,用最短的时间行动，可以管理。鼻内右美托咪定，它被认为是这项研究中最有效的药物，可以在择期儿科手术前40-50分钟给药。试验注册号：IRCT2013081614372N1。
