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Despite this common need, there is still a lack of options for adequate and safe analgesia and sedation in children. The objective of this study was to evaluate whether intranasal dexmedetomidine could provide more effective analgesia and sedation during a procedure than intranasal esketamine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a double-blind equally randomized (1:1) superiority trial of 30 children aged 1\u20133\u00a0years presenting to the Emergency Department with a laceration or a burn and requiring procedural sedation and analgesia. Patients were randomized to receive 2.0 mcg\/kg intranasal dexmedetomidine or 1.0\u00a0mg\/kg intranasal esketamine.<\/jats:p>\n                    <jats:p>The primary outcome measure was highest pain (assessed using Face, Legs, Activity, Cry, Consolability scale (FLACC)) during the procedure. Secondary outcomes were sedation depth, parents\u2019 satisfaction, and physician\u2019s assessment.<\/jats:p>\n                    <jats:p>Comparisons were done using Mann\u2013Whitney U test (continuous variables) and Fisher\u2019s test (categorical variables).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Adequate analgesia and sedation were reached in 28\/30 patients. The estimated sample size was not reached due to changes in treatment of minor injuries and logistical reasons. The median (IQR) of highest FLACC was 1 (0\u20133) with intranasal dexmedetomidine and 5 (2\u20136.75) with intranasal esketamine, (\n                      <jats:italic>p<\/jats:italic>\n                      -value 0.09). 85.7% of the parents with children treated with intranasal dexmedetomidine were \u201cvery satisfied\u201d with the procedure and sedation compared to the 46.2% of those with intranasal esketamine, (\n                      <jats:italic>p<\/jats:italic>\n                      -value 0.1). No severe adverse events were reported during this trial.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study was underpowered and did not show any difference between intranasal dexmedetomidine and intranasal esketamine for procedural sedation and analgesia in young children. However, the results support that intranasal dexmedetomidine could provide effective analgesia and sedation during procedures in young children aged 1\u20133\u00a0years with minor injuries.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Trial registration<\/jats:italic>\n                      : Eudra-CT 2017-00057-40, April 20, 2017.\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/eudract.ema.europa.eu\/\" ext-link-type=\"uri\">https:\/\/eudract.ema.europa.eu\/<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13049-024-01190-5","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T09:02:38Z","timestamp":1709542958000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["A randomized double-blind trial of intranasal dexmedetomidine versus intranasal esketamine for procedural sedation and analgesia in young children"],"prefix":"10.1186","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0263-8728","authenticated-orcid":false,"given":"Anna","family":"Nikula","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Lundeberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Ryd Rinder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitja","family":"L\u00e4\u00e4peri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katri","family":"Sandholm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maaret","family":"Castr\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Kurland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,4]]},"reference":[{"issue":"3","key":"1190_CR1","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.annemergmed.2021.10.008","volume":"79","author":"LK Lee","year":"2022","unstructured":"Lee LK, Porter JJ, Mannix R, Rees CA, Schutzman SA, Fleegler EW, et al. 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