Background: Intranasal dexmedetomidine premedication has been employed in children for
controlling stress before induction of general anesthesia. Until now, the effect of intranasal
dexmedetomidine in relation to other premeditations remains incompletely studied.
Objectives: This study was conducted to study the effectiveness and safety of intranasal
dexmedetomidine premedication in pediatrics.
Sittings: Meta-analysis-based study following the PRISMA (Preferred Reporting Items for
Systematic Reviews and Meta-Analyses) guidelines.
Methods: Systematic searches of the databases MEDLINE, EMBASE, PubMed, and Cochrane
were conducted to collect all published randomized, controlled, clinical trials in the last seven
years which compare the intranasal dexmedetomidine premedication with other methods of
premedication in different procedures.
Results: Twenty-five studies were collected for inclusion in this research including 2601
patients. The bias risk was low. Meta-analysis showed that the use of dexmedetomidine
intranasally as a premedication when compared with other premedication regimes results in
significant evidence of decreasing emergence agitation (RR = 0.64 [0.54, 0.77] 95% CI; I2 = 84%;
P = 0.0001) fewer sedation scores (Mean difference = 51 [0.38, 0.65]; 95% CI; I2 = 99%; P =
0.00001), significantly less incidence of postoperative nausea and vomiting ((RR = 0.30 [0.20,
0.45] 95% CI; I2 = 12%; P = 0.00001), significantly decreased BP ((Mean difference = -2.28 [−3.42,
−1.14]; 95% CI; I2 = 88%; P = 0.0001), and significantly decreased heart rate and (mean difference
= -6.67 [−8.37, −4.97]; 95% CI; I2 = 94%; P = 0.00001).
Conclusion: Intranasal dexmedetomidine provided a satisfactory level of emergence agitation,
more satisfactory sedation, more hemodynamic stability, and reduced the incidence of postoperative
complications in relation to other premeditations