Randomized Controlled Trial of Intranasal Midazolam vs Dexmedetomidine vs Ketamine Evaluating Length of Stay and Anxiolysis During Pediatric Procedures in Emergency Department

What this Trial Is About

Pain in young children is often under-recognized because they cannot clearly describe or locate it. This research is evaluating three intranasal medications—Midazolam, Dexmedetomidine, and Ketamine—to compare how long children stay in the emergency department after receiving these treatments for laceration repairs. The study aims to find which medication offers the best anxiety relief with the shortest hospital stay and highest satisfaction for patients and providers. Participants will be randomly assigned to receive one of three intranasal drugs: Midazolam, Dexmedetomidine, or Ketamine. Midazolam is commonly used but can cause nasal irritation and side effects like respiratory depression. Dexmedetomidine mimics sleep and is preferred for children with behavioral concerns, while Ketamine provides both anxiety relief and pain control. Dosing is weight-based, and medications are administered via a syringe designed to deliver small volumes to the nostrils. All three drugs are being studied for their effects during minor procedures in a pediatric emergency setting. Children aged 1 to 5 years with small lacerations will be monitored during their emergency department visit. Researchers will assess the time from medication administration to discharge, measure anxiety levels using the Modified Yale Preoperative Anxiety Scale (mYPAS), and gather satisfaction ratings from parents and physicians. Safety checks include monitoring vital signs and watching for side effects. The total participation is limited to the emergency visit day, with careful observation throughout the procedure and recovery.

IN Midazolam vs IN Dexmedetomidine vs IN Ketamine During Minimal Procedures in Pediatric ED