{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T08:08:55Z","timestamp":1778659735571,"version":"3.51.4"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,13]]},"DOI":"10.7759\/cureus.108763","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T07:18:39Z","timestamp":1778656719000},"source":"Crossref","is-referenced-by-count":0,"title":["Intranasal Dexmedetomidine Versus Esketamine As Premedication for the Sedation of Pediatric Patients: A Systematic Review and Meta-Analysis"],"prefix":"10.7759","author":[{"given":"Lelian","family":"Ghaly","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayat","family":"Al Nuaimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelrahman","family":"Ragab","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed O","family":"Gamal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud  M","family":"Asida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelrahman","family":"Sayed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad  M","family":"Alemam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manar","family":"Adel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Hesham Gamal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19169828","article-title":"Research progress on risk factors of preoperative anxiety in children: a scoping review","volume":"19","author":"Liu W","year":"2022","unstructured":"Liu W, Xu R, Jia J, Shen Y, Li W, Bo L. Research progress on risk factors of preoperative anxiety in children: a scoping review. Int J Environ Res Public Health. 2022, 19:9828. 10.3390\/ijerph19169828","journal-title":"Int J Environ Res Public Health"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-020-01317-x","article-title":"Emergence delirium in perioperative pediatric care: a review of current evidence and new directions","volume":"37","author":"Urits I","year":"2020","unstructured":"Urits I, Peck J, Giacomazzi S, et al.. Emergence delirium in perioperative pediatric care: a review of current evidence and new directions. Adv Ther. 2020, 37:1897-909. 10.1007\/s12325-020-01317-x","journal-title":"Adv Ther"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew477","article-title":"Paediatric emergence delirium: a comprehensive review and interpretation of the literature","volume":"118","author":"Mason KP","year":"2017","unstructured":"Mason KP. Paediatric emergence delirium: a comprehensive review and interpretation of the literature. Br J Anaesth. 2017, 118:335-43. 10.1093\/bja\/aew477","journal-title":"Br J Anaesth"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2006.01869.x","article-title":"A cohort study of the incidence and risk factors for negative behavior changes in children after general anesthesia","volume":"16","author":"Stargatt R","year":"2006","unstructured":"Stargatt R, Davidson AJ, Huang GH, Czarnecki C, Gibson MA, Stewart SA, Jamsen K. A cohort study of the incidence and risk factors for negative behavior changes in children after general anesthesia. Paediatr Anaesth. 2006, 16:846-59. 10.1111\/j.1460-9592.2006.01869.x","journal-title":"Paediatr Anaesth"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2017.02.015","article-title":"When to pick the nose: out-of-hospital and emergency department intranasal administration of medications","volume":"70","author":"Rech MA","year":"2017","unstructured":"Rech MA, Barbas B, Chaney W, Greenhalgh E, Turck C. When to pick the nose: out-of-hospital and emergency department intranasal administration of medications. Ann Emerg Med. 2017, 70:203-11. 10.1016\/j.annemergmed.2017.02.015","journal-title":"Ann Emerg Med"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000488","article-title":"Dexmedetomidine: the new all-in-one drug in paediatric anaesthesia?","volume":"30","author":"Sottas CE","year":"2017","unstructured":"Sottas CE, Anderson BJ. Dexmedetomidine: the new all-in-one drug in paediatric anaesthesia?. Curr Opin Anaesthesiol. 2017, 30:441-51. 10.1097\/ACO.0000000000000488","journal-title":"Curr Opin Anaesthesiol"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-021-03216-8","article-title":"Use of ketamine and esketamine for depression: an overview of systematic reviews with meta-analyses","volume":"78","author":"Lima TM","year":"2022","unstructured":"Lima TM, Visacri MB, Aguiar PM. Use of ketamine and esketamine for depression: an overview of systematic reviews with meta-analyses. Eur J Clin Pharmacol. 2022, 78:311-38. 10.1007\/s00228-021-03216-8","journal-title":"Eur J Clin Pharmacol"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/pan.70159","article-title":"Efficacy and safety of dexmedetomidine-esketamine versus dexmedetomidine alone as premedication for pediatric anesthesia induction: a systematic review, meta-analysis, and trial sequential analysis","volume":"36","author":"Lateiresh M","year":"2026","unstructured":"Lateiresh M, Altayf A, Qatza A, Alghazal A, Al-Sakkaf H, Elhadi M. Efficacy and safety of dexmedetomidine-esketamine versus dexmedetomidine alone as premedication for pediatric anesthesia induction: a systematic review, meta-analysis, and trial sequential analysis. Paediatr Anaesth. 2026, 36:617-27. 10.1002\/pan.70159","journal-title":"Paediatr Anaesth"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S488706","article-title":"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","volume":"18","author":"Liao Y","year":"2024","unstructured":"Liao Y, Xie S, Zhuo Y, Chen S, Luo Y, Wei Y, Yao Y. 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 Des Devel Ther. 2024, 18:4693-703. 10.2147\/DDDT.S488706","journal-title":"Drug Des Devel Ther"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.ED000142","article-title":"Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions","volume":"10","author":"Cumpston M","year":"2019","unstructured":"Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, Thomas J. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev. 2019, 10:ED000142. 10.1002\/14651858.ED000142","journal-title":"Cochrane Database Syst Rev"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al.. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021, 372:n71. 10.1136\/bmj.n71","journal-title":"BMJ"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne JA","year":"2019","unstructured":"Sterne JA, Savovi\u0107 J, Page MJ, et al.. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019, 366:l4898. 10.1136\/bmj.l4898","journal-title":"BMJ"},{"key":"ref13","unstructured":"The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. (2000). Accessed. 2026: https:\/\/ohri.ca\/en\/who-we-are\/core-facilities-and-platforms\/ottawa-methods-centre\/newcastle-ottawa-scale."},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.808930","article-title":"A comparison of intranasal dexmedetomidine, esketamine or a dexmedetomidine-esketamine combination for induction of anaesthesia in children: a randomized controlled double-blind trial","volume":"12","author":"Lu X","year":"2021","unstructured":"Lu X, Tang L, Lan H, Li C, Lin H. A comparison of intranasal dexmedetomidine, esketamine or a dexmedetomidine-esketamine combination for induction of anaesthesia in children: a randomized controlled double-blind trial. Front Pharmacol. 2021, 12:808930. 10.3389\/fphar.2021.808930","journal-title":"Front Pharmacol"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-024-01190-5","article-title":"A randomized double-blind trial of intranasal dexmedetomidine versus intranasal esketamine for procedural sedation and analgesia in young children","volume":"32","author":"Nikula A","year":"2024","unstructured":"Nikula A, Lundeberg S, Ryd Rinder M, L\u00e4\u00e4peri M, Sandholm K, Castr\u00e9n M, Kurland L. A randomized double-blind trial of intranasal dexmedetomidine versus intranasal esketamine for procedural sedation and analgesia in young children. Scand J Trauma Resusc Emerg Med. 2024, 32:16. 10.1186\/s13049-024-01190-5","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1097\/WNF.0000000000000637","article-title":"The impact of preoperative low-dose esketamine and dexmedetomidine nasal administration on the emergence delirium in children undergoing fiber bronchoscopy: a prospective randomized controlled trial","volume":"48","author":"Xie W","year":"2025","unstructured":"Xie W, Wang L, Peng Z, et al.. The impact of preoperative low-dose esketamine and dexmedetomidine nasal administration on the emergence delirium in children undergoing fiber bronchoscopy: a prospective randomized controlled trial. Clin Neuropharmacol. 2025, 48:97-103. 10.1097\/WNF.0000000000000637","journal-title":"Clin Neuropharmacol"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.21037\/tp-21-435","article-title":"Comparison between dexmedetomidine and esketamine in pediatric dentistry surgery","volume":"10","author":"Xin N","year":"2021","unstructured":"Xin N, Xu H, Yue C. Comparison between dexmedetomidine and esketamine in pediatric dentistry surgery. Transl Pediatr. 2021, 10:3159-65. 10.21037\/tp-21-435","journal-title":"Transl Pediatr"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-022-02305-1","article-title":"Efficacy and safety of intranasal ketamine compared with intranasal dexmedetomidine as a premedication before general anesthesia in pediatric patients: a systematic review and meta-analysis of randomized controlled trials","volume":"69","author":"Dwivedi P","year":"2022","unstructured":"Dwivedi P, Patel TK, Bajpai V, Singh Y, Tripathi A, Kishore S. Efficacy and safety of intranasal ketamine compared with intranasal dexmedetomidine as a premedication before general anesthesia in pediatric patients: a systematic review and meta-analysis of randomized controlled trials. Can J Anaesth. 2022, 69:1405-18. 10.1007\/s12630-022-02305-1","journal-title":"Can J Anaesth"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-026-03628-y","article-title":"Intranasal esketamine plus dexmedetomidine versus dexmedetomidine alone for emergence delirium in pediatric patients: a systematic review and meta-analysis of randomized controlled trials","volume":"26","author":"Wang Y","year":"2026","unstructured":"Wang Y, Liu C, Wu Y, et al.. Intranasal esketamine plus dexmedetomidine versus dexmedetomidine alone for emergence delirium in pediatric patients: a systematic review and meta-analysis of randomized controlled trials. BMC Anesthesiol. 2026, 26:114. 10.1186\/s12871-026-03628-y","journal-title":"BMC Anesthesiol"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2020.00330","article-title":"Mechanisms of dexmedetomidine in neuropathic pain","volume":"14","author":"Zhao Y","year":"2020","unstructured":"Zhao Y, He J, Yu N, Jia C, Wang S. Mechanisms of dexmedetomidine in neuropathic pain. Front Neurosci. 2020, 14:330. 10.3389\/fnins.2020.00330","journal-title":"Front Neurosci"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e318176be73","article-title":"Dexmedetomidine enhances the local anesthetic action of lidocaine via an alpha-2A adrenoceptor","volume":"107","author":"Yoshitomi T","year":"2008","unstructured":"Yoshitomi T, Kohjitani A, Maeda S, Higuchi H, Shimada M, Miyawaki T. Dexmedetomidine enhances the local anesthetic action of lidocaine via an alpha-2A adrenoceptor. Anesth Analg. 2008, 107:96-101. 10.1213\/ane.0b013e318176be73","journal-title":"Anesth Analg"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.01.035","article-title":"Does intranasal dexmedetomidine provide adequate plasma concentrations for sedation in children: a pharmacokinetic study","volume":"120","author":"Miller JW","year":"2018","unstructured":"Miller JW, Balyan R, Dong M, et al.. Does intranasal dexmedetomidine provide adequate plasma concentrations for sedation in children: a pharmacokinetic study. Br J Anaesth. 2018, 120:1056-65. 10.1016\/j.bja.2018.01.035","journal-title":"Br J Anaesth"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2004.01358.x","article-title":"S-ketamine and s-norketamine plasma concentrations after nasal and i.v. administration in anesthetized children","volume":"14","author":"Weber F","year":"2004","unstructured":"Weber F, Wulf H, Gruber M, Biallas R. S-ketamine and s-norketamine plasma concentrations after nasal and i.v. administration in anesthetized children. Paediatr Anaesth. 2004, 14:983-8. 10.1111\/j.1460-9592.2004.01358.x","journal-title":"Paediatr Anaesth"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1515\/biol-2022-0816","article-title":"The role and mechanism of esketamine in preventing and treating remifentanil-induced hyperalgesia based on the NMDA receptor-CaMKII pathway","volume":"19","author":"Wang J","year":"2024","unstructured":"Wang J, Feng Y, Qi Z, Li J, Chen Z, Zhang J, Zhu D. The role and mechanism of esketamine in preventing and treating remifentanil-induced hyperalgesia based on the NMDA receptor-CaMKII pathway. Open Life Sci. 2024, 19:20220816. 10.1515\/biol-2022-0816","journal-title":"Open Life Sci"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-023-01611-z","article-title":"Risk of esketamine anesthesia on the emergence delirium in preschool children after minor surgery: a prospective observational clinical study","volume":"274","author":"Chen S","year":"2024","unstructured":"Chen S, Yang JJ, Zhang Y, et al.. Risk of esketamine anesthesia on the emergence delirium in preschool children after minor surgery: a prospective observational clinical study. Eur Arch Psychiatry Clin Neurosci. 2024, 274:767-75. 10.1007\/s00406-023-01611-z","journal-title":"Eur Arch Psychiatry Clin Neurosci"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/484621-intranasal-dexmedetomidine-versus-esketamine-as-premedication-for-the-sedation-of-pediatric-patients-a-systematic-review-and-meta-analysis","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T07:18:44Z","timestamp":1778656724000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/484621-intranasal-dexmedetomidine-versus-esketamine-as-premedication-for-the-sedation-of-pediatric-patients-a-systematic-review-and-meta-analysis"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":25,"URL":"https:\/\/doi.org\/10.7759\/cureus.108763","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5,13]]}}}