ReviewFrontiers in pediatrics2023
Intranasal dexmedetomidine vs. oral midazolam for premedication in children: a systematic review and meta-analysis.
Review in Frontiers in pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 5 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Chinese Society of Pediatric Anesthesiology Guideline for Pediatric Sedation (2025).Paediatric anaesthesia · 2026Guideline
- Comparative safety and sedation effectiveness of intranasal dexmedetomidine versus midazolam for preoperative anxiety reduction in pediatric surgical patients: an updated systematic review and meta-analysis.BMC anesthesiology · 2026Pooled it
- Intranasal esketamine plus dexmedetomidine versus dexmedetomidine alone for emergence delirium in pediatric patients: a systematic review and meta-analysis of randomized controlled trials.BMC anesthesiology · 2026Pooled it
- Intranasal dexmedetomidine versus midazolam for pediatric dental sedation: a pooled analysis of clinical trials.Frontiers in medicine · 2026Pooled it
- Efficacy and safety of preoperative intranasal dexmedetomidine in adults: a systematic review and meta-analysis of randomized controlled trials.Brazilian journal of anesthesiology (Elsevier)Pooled it
- Safety, pharmacokinetics, and pharmacodynamics of Dexmedetomidine two-phase flow atomization in healthy subjects: a randomized, parallel study.BMC anesthesiology · 2025Trial
- Efficacy of Intranasal Dexmedetomidine Premedication as an Adjunct on Intubation Process in Paediatric Patients: A Randomized, Double-blind, Placebo-controlled Trial.Turkish journal of anaesthesiology and reanimation · 2026Article
- Intranasal dexmedetomidine as a single sedative agent for pediatric magnetic resonance imaging: a single-center observational cohort study.European journal of pediatrics · 2026Observational
- The consensus statement of the Section of Paediatric Anaesthesiology and Intensive Therapy of the Polish Society of Anaesthesiology and Intensive Therapy on anaesthesia in children over 3 years of age.Anaesthesiology intensive therapy · 2025Article
- Commentary: Are Anesthesiologists Still "Darting" Their Patients?Anesthesia progress · 2025Article
- Intranasal dexmedetomidine reduces pain scores in preterm infants during retinopathy of prematurity screening.Frontiers in pediatrics · 2024Article
- Intranasal dexmedetomidine sedation for EEG in children with autism spectrum disorder.Frontiers in psychiatry · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To compare the effects of intranasal dexmedetomidine (Dex) and oral midazolam in the preoperative medication of children by using a method of meta-analysis. Methods: Cochrane Library, Pubmed, Embase, and Web of Science were searched from inception to July 2023. Randomized controlled trials (RCTs) of intranasal Dex vs. oral midazolam in pediatric premedication were collected. Stata 15.0 statistical software was used to analyze the collected data. Relative risk (RR) and 95% confidence interval (CI) were used as effect sizes. Results: A total of 11 studies with 824 children were included, containing 415 patients in the Dex group and 409 patients in the midazolam group. Compared with the oral midazolam group, the intranasal Dex group had a better preoperative sedation effect at parent-child separation (RR = 1.37, 95% CI: 1.14-1.64) and anesthesia induction (RR = 2.08, 95% CI: 1.03-4.22). In addition, there was no significant difference in the incidence of analgesia remedy (RR = 0.60, 95% CI: 0.36-1.00) the acceptance of anesthesia masks (RR = 0.97, 95% CI: 0.83-1.12), and incidence of adverse events between (RR = 0.25, 95% CI: 0.06-1.13, Conclusion: Compared with oral midazolam, intranasal Dex has better sedative effects of parent-child separation and anesthesia induction in pediatric premedication, but there was no difference in the incidence of anesthesia remedy, anesthesia mask acceptance, and incidence of adverse events. Therefore, compared with oral midazolam, intranasal Dex is a better choice for premedication in children.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.