Comparing Ketofol and Dexmedetomidine to Prevent Emergence Delirium in Children Aged 2 to 6 Undergoing Squint Surgery

What this Trial Is About

Researchers are evaluating the effectiveness of ketofol compared to dexmedetomidine for preventing emergence delirium in children aged 2 to 6 years undergoing squint surgery. This prospective randomized controlled double-blinded study aims to compare the incidence of emergence delirium ED and assess the side effects of both drugs on heart rate, blood pressure, recovery time, nausea, and vomiting. The study is conducted at Specialized Children Hospital, Cairo University, with ethical approval and informed consent from parents. Participants are randomly assigned to one of two groups one group receives dexmedetomidine infusion at 0.2 mcgkghr starting five minutes after securing the airway, while the other group receives ketofol a mixture of ketamine and propofol in a 14 ratio infusion at 0.6 mlkghr starting five minutes after induction. Standard anesthesia and surgical procedures are followed, including monitoring vital signs and administering premedications. Infusions are stopped ten minutes before surgery ends, and patients receive paracetamol for pain relief. After surgery, patients are extubated and moved to the post-anesthesia care unit PACU. During their PACU stay, children are closely monitored for delirium using the Pediatric Anesthesia Emergence Delirium PAED scale at multiple intervals up to 30 minutes after extubation. Pain is assessed with the FLACC scale, and rescue sedation or analgesia is given as needed. Vital signs and possible complications like bradycardia or hypotension are recorded throughout. The study measures the incidence of ED on arrival at PACU as the primary outcome, along with secondary outcomes including intraoperative and postoperative vital signs, sedation and analgesia usage, nausea, vomiting, and PACU stay duration.

Ketofol Versus Dexmedetomidine for Prevention of Emergence Delirium in Pediatric Patients Undergoing Squint Surgeries