Intranasal combined dexmedetomidine and intranasal midazolam-ketamine sedation efficacy and associations in childhood strabismus surgery
Reviewed by Fiona Rowe

The aim of this study was to compare the efficacy of intranasal combined dexmedetomidine (D) and intranasal midazolam-ketamine (MK) sedation and their effects on the occurrence of oculocardiac reflex in children’s strabismus surgery. The study recruited 37 children to each group with 32 male and 42 female in each group. There was no difference between groups for age, sex, weight and surgery duration, or for the Ramsay Sedation Scale. Preoperative heart rates in the D group were significantly lower at 10 minutes and thereafter, and with significantly lower mean arterial pressure values at 25 and 30 minutes. During the intraoperative period, heart rate values at 40 minutes were significantly lower for the D group but with a higher incidence of oculocardiac reflex. There was no difference for atropine requirement, nausea and vomiting scores. Postoperative agitation rate was significantly higher for the D group and with a significantly shorter recovery time. The authors conclude both groups had suitable sedation conditions in the preoperative period. There were more oculocardiac reflex events in the D group but more postoperative agitation. Postoperative recovery time was longer for the MK group.

Evaluation of the perioperative effects of dexmedetomidine and midazolam-ketamine premedication in strabismus surgery.
Yildirim MY, Ulgey A, Talih G, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2023;60:427–34.