Skip to main content Skip to main navigation menu Skip to site footer


Introduction: Surgery in special population such as children may lead to emotional and physical stress. Premedication use may be beneficial in children anesthesia to reduce emotional stress and anxiety but still to be used in special consideration with adjustment dose. Intranasal premedication provides a broad effect of sedation and anti-anxiety and maybe produce a beneficial effect in child anesthesia.

Aim: This study aimed to provide an overview regarding intranasal drugs and also intranasal premedication function in children

Conclusion: The intranasal application of pre-anesthetic drugs is the preferred route of administration and is an effective way to provide sedatives to children.


  1. Hassani V, Amanni A, Poureslami M, Motlagh SD. Paediatric Premedication: A Comparison Of Sublingual Buprenorphine And Midazolam In Children (4-10 Years) Scheduled For Adenotonsillectomy. Iranian Journal Of Pharmacology & Therapeutics. 2002;1(1):113-118.
  2. Abdallah C, Hannallah R. Premedication Of The Child Undergoing Surgery. M.E.J. Anesth. 2011;21(2):202-208.
  3. Messeha MM, El-Morsy GZ. Comparison of intranasal dexmedetomidine compared to midazolam as a premedication in pediatrics with congenital heart disease undergoing cardiac catheterization. Anesth Essays Res. 2018;12:170-5.
  4. Sheen MJ, Chang FL, Ho ST. Anesthetic premedication: New horizons of an old practice. Acta Anaesthesiologica Taiwanica. 2014;52:134-142
  5. Woolf CJ, Chong MS. Preemptive analgesia-treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg. 1993;77: 362e79.
  6. Ong CK, Lirk P, Seymour RA, Jenkins BJ. The efficacy of preemptive analgesia for acute postoperative pain management: a meta-analysis. Anesth Analg. 2005;100:757e73.
  7. Matana M, Laihad M, Tambajong H. Effect of midazolam premedication with dose 0.05 mg to heart rate and blood pressure. J E-Biomedik (EBM) 2013;1(1):691-696.
  8. Reddi D, Curran N. Chronic pain after surgery: pathophysiology, risk factors and prevention. Postgrad Med J. 2014;90:222e7.
  9. Chandrakantan A, Glass PSA. Multimodal therapies for postoperative nausea and vomiting and pain. Br J Anaesth. 2011;107(Suppl. 1):i27e40.
  10. Apfel CC, Philip BK, Cakmakkaya OS, Shilling A, Shi YY, Leslie JB, et al. Who is at risk for postdischarge nausea and vomiting after ambulatory surgery? . Anesthesiology. 2012;117:475e86.
  11. Clark K, Lam LT, Gibson S, Currow D. The effect of ranitidine versus proton pump inhibitors on gastric secretions: a meta-analysis of randomised control trials. Anesthesia. 2009;64:652e7.
  12. Shapiro F, Athiraman U, Clendenin DJ, Hoagland M, Sethna NF. Anesthetic management of 877 pediatric patients undergoing muscle biopsy for neuromuscular disorders: a 20-year review. Pediatr Anaesth. 2016; 26:710-721.
  13. Rakaf AL, Bello LL, Turkustani A, Adenubi JO. Intranasal midazolam in conscious sedation of young paediatric dental patients. Int J Paediatr Dent. 2011; 11:33-40.
  14. Fantacci1 C, Fabrizio GC, Ferrara P, Franceschi F, Chiaretti A. Intranasal drug administration for procedural sedation in children admitted to pediatric Emergency Room. European Review for Medical and Pharmacological Sciences. 2018; 22:217-222
  15. Roberts M, Stuart G. Dexmedetomidine in paediatric anaesthesia and intensive care. Anaesthesia Tutorial of The Week. 2013;293:1-6.
  16. Scott-Warren VL, Sebastian J. Dexmedetomidine: its use in intensive care medicine and anaesthesia, BJA Education. 2016;16(7):242-46.
  17. Yazbek-Karam VG, Aouad MM. Perioperative use of Dexmedetomidine. MEJ Anesth. 2006;8(6):1043-58.
  18. Larsson P. Clonidine in Pediatric Anesthesia Aspects on population pharmacokinetics, nasal administration and safety. Stockholm Journal of Medicine. 2014;2(3):2-17.
  19. Yuen VM, Hui TW, Irwin MG, Yao TJ, Wong GL, Yuen MK, et al. Optimal timing for the administration of intranasal dexmedetomidine for premedication in children. Anesthesia. 2010;65:922-9.
  20. Wolfe TR, Braude DA. Intranasal medication delivery for children: A brief review and update. Pediatrics. 2010;126:532-7.

How to Cite

Arnawa, I. W. E. (2018). Intranasal premedication: special consideration in children. Intisari Sains Medis, 9(3).




Search Panel

I Wayan Eka Arnawa
Google Scholar
ISM Journal