Ketofol versus Dexmedetomidine for Prevention of Emergence Delirium in Pediatric Patients Undergoing Squint Surgeries: A Randomized Clinical Study

Authors

  • Kareem Mohammed Assem Nawwar Department of Anesthesia, Surgical Intensive Care, and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
  • Muhammad Khalaf Ibrahim Ali Department of Anesthesia, Surgical Intensive Care, and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
  • Omnia Yahia El Sayed Kamel Department of Anesthesia, Surgical Intensive Care, and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
  • Hany Mohammed Elhadi Shaukat Department of Anesthesia, Surgical Intensive Care, and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
  • Karim Kamal Fahim Girgis Department of Anesthesia, Surgical Intensive Care, and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
  • Mohamed Elsayed AbdelFatah Mohammed Department of Anesthesia, Surgical Intensive Care, and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.

DOI:

https://doi.org/10.18502/aacc.v12i6.22962

Keywords:

Ketofol; Dexmedetomidine; Emergence delirium; Pediatric; Squint

Abstract

Background: A common adverse event in pediatric patients after surgery is emergence delirium (ED), which manifests as agitation, disorientation, and changes in perception (such as hypersensitivity to stimuli) together with inconsolable crying and moaning. This study compared the efficacy of ketofol versus dexmedetomidine (DEX) in preventing ED in children undergoing squint surgeries.

Methods: This prospective, randomized, clinical double-blind study enrolled 52 children aged 2–6 years, of both sexes, undergoing squint surgery. Patients were divided into two equal groups. Five minutes after securing the airway, DEX was infused at 0.2 µg/kg/h in Group D, and Ketofol (1:4 ketamine to propofol) was infused at 80 µg/kg/min propofol and 20 µg/kg/min ketamine in Group K.

Results: The incidence of intraoperative bradycardia and hypotension was not substantially different between the two groups. There was no significant difference in heart rate, mean arterial blood pressure, or peripheral oxygen saturation between groups intraoperatively and postoperatively. PAED and FLACC scores were insignificantly different between the two groups. Postoperative rescue analgesia and rescue sedation showed insignificant differences between groups.

Conclusion: Ketofol and DEX are equally effective in preventing emergence delirium (ED) in children undergoing squint surgery while maintaining stable hemodynamics.

Published

2026-10-19

Issue

Volume (12) issue (6)

Section

Articles