{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T23:21:34Z","timestamp":1781911294788,"version":"3.54.5"},"reference-count":24,"publisher":"Termedia Sp. z.o.o.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesthesiol Intensive Ther"],"abstract":"Introduction<\/jats:title>Sedative premedication may hold notable significance in pediatric patients undergoing diagnostic and interventional cardiac catheterization, as it minimizes\n\nanxiety, facilitates parental separation, and allows for the acceptance of inhalational\n\ninduction. The intranasal route is a reliable method for administering sedatives as pre-\nmedication in pediatric patients. This study compared and evaluated the sedative\n\neffects of intranasal dexmedetomidine versus intranasal midazolam as premedication in\npediatric patients undergoing transcatheter closure of ventricular septal defects.<\/jats:p><\/jats:sec>Material and methods<\/jats:title>This prospective, randomized, double-blind study included 40 pediatric patients aged 3 to 6 years scheduled for transcatheter perimembranous VSD closure under\n\ngeneral anesthesia. The subjects were randomly assigned to receive either intranasal\nmidazolam at 0.2 mg kg<sup>\u20131<\/sup> body mass or intranasal dexmedetomidine at 0.5 \u03bcg kg<sup>\u20131<\/sup>\nbody mass. The primary outcome measured was the effect of preoperative sedatives\n\non the Ramsay sedation score. Secondary outcomes included the child-parent separation score, child emergence agitation level, effects on hemodynamics, and oxygen\n\nsaturation.<\/jats:p><\/jats:sec>Results<\/jats:title>This study included 40 individuals with similar demographic profiles and comparable duration of the procedure (<i>P<\/i> = 0.152) in both groups. No statistically significant\n\ndifferences were detected in the Ramsay sedation score (<i>P<\/i> = 0.582), child-parent separation score (<i>P<\/i> = 1.000) 20 minutes after drug administration, or postoperative child emergence agitation level (<i>P<\/i> = 0.351). No statistically significant difference was observed in\n\nterms of blood pressure, heart rate and oxygen saturation between the two groups.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Pediatric patients were successfully and effectively sedated with both\nintranasal dexmedetomidine and intranasal midazolam, with stable hemodynamics and\noxygen saturation.<\/jats:p><\/jats:sec>","DOI":"10.5114\/ait\/200231","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T07:10:03Z","timestamp":1750144203000},"page":"115-120","source":"Crossref","is-referenced-by-count":2,"title":["Intranasal dexmedetomidine versus intranasal midazolam as a standard of care for pediatric patients undergoing transcatheter perimembranous ventricular septal defect (VSD) closure: a randomized controlled trial"],"prefix":"10.5114","volume":"57","author":[{"given":"Mohammed Saed","family":"Shorbagy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramy","family":"Mahrose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr A.","family":"Kasem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmin Abdelrazik","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally Hamdy","family":"Abdelaziz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3061","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"ref-1459103","doi-asserted-by":"publisher","DOI":"10.1016\/j.egja.2012.10.006"},{"key":"ref-1459104","unstructured":"Kidd L, Discroll DJ, Gersony WH, Hayes CJ, Keane JF, O\u2019Fallon WM, et al. Second natural history study of congenital heart defects: results of treatment of patients with ventricular septal defects. Circulation 1993; 87 (2 Suppl): l138-l151."},{"key":"ref-1459105","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.10292"},{"key":"ref-1459106","doi-asserted-by":"crossref","unstructured":"Bailey AM, Baum RA, Horn K, Lewis T, Morizio K, Schultz A, et al. Review of intranasally administered medications for use in the emergency department. J Emerg Med 2017; 53: 38-48. DOI: 10.1016\/ j.jemermed.2017.01.020.","DOI":"10.1016\/j.jemermed.2017.01.020"},{"key":"ref-1459107","unstructured":"Satervas Y, Gonzalez M, Duran C. Manual de Analgesia y Sedaci\u00f3n en Urgencias de Pediatr\u00eda. 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Influence of intranasal medication on the structure of the nasal mucosa. Chin Med J (Engl) 2002; 115: 617-619."},{"key":"ref-1459116","doi-asserted-by":"crossref","unstructured":"Saad BB, Tharwat AI, Ghobrial HN, Elfawal SM. Intranasal dexmedetomidine versus intranasal midazolam as pre-anesthetic medication in pediatric age group undergoing adenotonsillectomy. Ain-Shams Journal of Anesthesiology 2020; 12: 1-0.","DOI":"10.1186\/s42077-020-00090-x"},{"key":"ref-1459117","doi-asserted-by":"publisher","DOI":"10.4103\/aer.AER_119_17"},{"key":"ref-1459118","doi-asserted-by":"publisher","DOI":"10.5414\/CP202099"},{"key":"ref-1459119","doi-asserted-by":"crossref","unstructured":"Cimen ZS, Hanci A, Sivrikaya GU, Kilinc LT, Erol MK. Comparison of buccal and nasal dexmedetomidine premedication for pediatric patients. Pediatr Anesth 2013; 23: 134-138.","DOI":"10.1111\/pan.12025"},{"key":"ref-1459120","doi-asserted-by":"crossref","unstructured":"Mellion SA, Bourne D, Brou L, Brent A, Adelgais K, Galinkin J, Wathen J. Evaluating clinical effectiveness and pharmacokinetic profile of atomized intranasal midazolam in children undergoing laceration repair. J Emerg Med 2017; 53: 397-404. DOI: 10.1016\/ j.jemermed.2017.05.029.","DOI":"10.1016\/j.jemermed.2017.05.029"},{"key":"ref-1459121","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12998"},{"key":"ref-1459122","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12287"},{"key":"ref-1459123","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200411000-00005"},{"key":"ref-1459124","doi-asserted-by":"crossref","unstructured":"Akin A, Bayram A, Esmaoglu A, Tosun Z, Aksu R, Altuntas R, Boyaci A. Dexmedetomidine vs. midazolam for premedication of pediatric patients undergoing anesthesia. Paediatr Anaesth 2012; 22: 871-876.","DOI":"10.1111\/j.1460-9592.2012.03802.x"},{"key":"ref-1459125","doi-asserted-by":"crossref","unstructured":"Bergese SD, Patrick Bender S, McSweeney TD, Fernandez S, Dzwonczyk R, Sage K. A comparative study of dexmedetomidine with midazolam and midazolam alone for sedation during elective awake fiberoptic intubation. J Clin Anesth 2010; 22: 35-40. 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