Intranasal Dexmedetomidine-Esketamine Combination Premedication versus Monotherapy for Reducing Emergence Delirium and Postoperative Behavioral Changes in Pediatric Tonsillectomy and/or Adenoidectomy: A Randomized Controlled Trial.
Drug design, development and therapy January 1, 2024 Yanling Liao, Siyu Xie, Yifen Zhuo et al. 14 citations
In children aged 2-5 years undergoing tonsillectomy and/or adenoidectomy with sevoflurane anesthesia, intranasal premedication combining dexmedetomidine and esketamine reduces emergence delirium more effectively than esketamine alone (9.4% vs 38.1%) and reduces postoperative negative behavioral changes at day 7 more effectively than dexmedetomidine alone (28.1% vs 48.4%). The combination also provides better sedation, easier separation from parents, better mask acceptance, shorter emergence time, and higher parental satisfaction than either drug alone, without significant adverse effects. No significant difference in emergence delirium was found between the combination and dexmedetomidine alone.