Evaluating Intranasal Sufentanil-Ketamine for Preoperative Sedation in Children: A Case-Control Study Publisher



Ostadalipour A ; Samimi S ; Malekianzadeh B ; Nazari N ; Espahbodi E ; Maghsoudloo M ; Goudarzi V ; Kianpour P ; Samadi S ; Etezadi F
Source: Journal of Pediatric Surgery Open Published:2025

Abstract

Background: Hospitalization and surgical procedures can cause significant emotional distress in children aged 3 to 7. This study aimed to assess the efficacy and safety of intranasal (IN) sufentanil-ketamine (SK) for preoperative sedation and evaluate parental satisfaction scores in children undergoing strabismus surgery under general anesthesia. Method: This observational case study included sixty children aged 3 to 7 years with ASA physical status I/II at Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Participants were divided into two groups: those receiving IN SK group and those not receiving pre-anesthetic sedation (C group). The SK group received 0.5 µg/kg sufentanil and 0.5 mg/kg ketamine intranasally 20 min before anesthesia. Heart rate (HR), systolic blood pressure (SBP), and oxygen saturation (SpO2) were recorded at baseline and 15 min post-intervention. Sedation levels were assessed using the University of Michigan Sedation Scale (UMSS), and parental separation anxiety was evaluated using the Parental Separation Anxiety Scale (PSAS). Results: There were no significant differences in demographics or baseline HR, SBP, and SpO2 between groups. However, the SK group had significantly higher sedation levels (P < 0.001), with 83.4 % achieving satisfactory sedation compared to none in the C group. The SK group also had significantly more favorable parental separation scores (P = 0.001). Side effects were minimal, with nausea and vomiting in only one patient (3.3 %) in the SK group. Conclusion: IN SK is effective and safe for preoperative sedation in children undergoing strabismus surgery. It provides satisfactory sedation and facilitates easier separation from parents with minimal side effects, making it a viable alternative for pediatric pre-anesthetic sedation. © 2025 The Authors