Comparative Study between Intranasal Dexmedetomidine and Intranasal Ketamine as a Premedication for Anxiolysis and Sedation before Pediatric General Anesthesia

Abstract

Surgery is a stressful and fearful event that the child face every day and the children cannot deal with such situations, they have a lot of issues and concerns about the surgical procedure, OR, strange peoples and environment, needles and syringes, the children have after that a very bad experience and it may let psychological impact on them, and this fear and anxiety may obstruct the anesthesia induction or may prolong it, may make the procedure of cannulation is very difficult in addition to the stress and anxiety at parents and their bad experience also. The modern anesthesia practice developed many techniques to alleviate or decrease stress and anxiety starting from parent and child education, preoperative clinic visits, reassurance from anesthesiologist to parents and child, distraction techniques, use of sedatives and anxiolytics in the preoperative period via intramuscular route, oral route and finally by intranasal application of drugs by instillation of the drug directly in the nasal cavity. Intranasal route is a very effective route of administration as nasal cavity highly vascularized and bypasses the hepatic metabolism and provides high serum levels of drug to attain a higher degree of sedation and