Date of Award

Spring 5-2025

Document Type

Scholarly Project

First Advisor

Solberg, Julie

Keywords

pediatric, children, laceration repair, suture, anxiolytic, administration intranasal, intranasal midazolam, intranasal dexmedetomidine, emergency treatment, parent satisfaction

Abstract

Pediatric laceration repair is a common, yet anxiety-inducing procedure for patients who must undergo them, with limited research analyzing the different types of pre-procedural anxiolytic medications. The purpose of this research and literature review was to analyze two different, but commonly used intranasal anxiolytics, dexmedetomidine and midazolam, and to compare the efficacy, adverse effects, and overall pediatric anxiety and parental satisfaction. Only articles including clinical trials and pediatric participants were included. A combination of keywords and MeSH phrases included, but were not limited to “pediatric”, “laceration repair”, “anxiolytic”, “administration intranasal”, “intranasal midazolam”, “intranasal dexmedetomidine”, and “parent satisfaction” were used to find relevant articles for each theme. Meta-analyses, animal studies, dental procedures, imaging procedures, full sedation procedures, and ongoing studies were excluded. In terms of effective anxiolysis, intranasal dexmedetomidine at a 2 or 3 ug/kg dose should be considered the preferred intranasal medication for pediatric laceration repair procedures as it significantly reduced anxiety levels during laceration repair and increased parental satisfaction scores without having any reported significant adverse effects. Counteractively, intranasal midazolam, when administered at a dose of 0.4 mg/kg 5mg/mL solution also revealed a decrease in pediatric anxiety, but also imposed vomiting adverse effects. Therefore, intranasal dexmedetomidine (IND) is preferred. Future studies regarding IND’s bioavailability, pharmacokinetics, and optimal doses per age or weight groups could be considered in the future for further supportive evidence.

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