Trial reportScandinavian journal of trauma, resuscitation and emergency medicine2024
A randomized double-blind trial of intranasal dexmedetomidine versus intranasal esketamine for procedural sedation and analgesia in young children.
Trial report in Scandinavian journal of trauma, resuscitation and emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 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
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.
- Chinese Society of Pediatric Anesthesiology Guideline for Pediatric Sedation (2025).Paediatric anaesthesia · 2026Guideline
- Pooled it
- Intranasal dexmedetomidine vs. nitrous oxide for procedural sedation in juvenile idiopathic arthritis (INDEXJIA): a randomized crossover clinical trial.European journal of pediatrics · 2026Trial
- A randomized clinical trial of intranasal dexmedetomidine versus inhaled nitrous oxide for procedural sedation and analgesia in children.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Trial
- Intranasal Dexmedetomidine for Paediatric Procedural Sedation in the Emergency Department: A Single-Centre Retrospective Observational Cohort Study.Emergency medicine Australasia : EMA · 2026Observational
- Review
- Emerging Sedation Strategies in Pediatric Emergency Care: Pharmacological Advances and Clinical Applications.Cureus · 2026Review
- Clinical efficacy and safety evaluation of dexmedetomidine hydrochloride nasal spray for sedation before examinations in children aged 2 to 6 years: protocol for a randomized controlled trial.Frontiers in pediatrics · 2026Article
- Comment on "A randomized double-blind trial of intranasal dexmedetomidine versus intranasal esketamine for procedural sedation and analgesia in young children".Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- A wrong conclusion.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- Comparison of fentanyl and dexmedetomidine versus fentanyl and midazolam in procedural sedation for tube thoracostomy in emergency department - A randomized control study.Turkish journal of emergency medicineArticle
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProcedural sedation and analgesia are commonly used in the Emergency Departments. 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.
methodsThis was a double-blind equally randomized (1:1) superiority trial of 30 children aged 1-3 years 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 mg/kg intranasal esketamine. 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' satisfaction, and physician's assessment. Comparisons were done using Mann-Whitney U test (continuous variables) and Fisher's test (categorical variables).
resultsAdequate 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 (0-3) with intranasal dexmedetomidine and 5 (2-6.75) with intranasal esketamine, (p-value 0.09). 85.7% of the parents with children treated with intranasal dexmedetomidine were "very satisfied" with the procedure and sedation compared to the 46.2% of those with intranasal esketamine, (p-value 0.1). No severe adverse events were reported during this trial.
conclusionsThis 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 1-3 years with minor injuries.
trial registrationEudra-CT 2017-00057-40, April 20, 2017. https://eudract.ema.europa.eu/.
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What OpenQuestion holds
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.