Cleft Lip and Palate Clinical Trials

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Comparison of Intramuscular Ketamine and Intranasal Nalbuphine and Dexmedetomidine for Analgosedation in Children Undergoing Suture Removal After Surgery for Congenital Clefts of the Palate, Alveolar Ridge, and Lip

Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

This prospective, randomized study is designed to compare the efficacy and safety of three sedative-analgesic agents-intramuscular ketamine, intranasal nalbuphine, and intranasal dexmedetomidine-for procedural sedation in children undergoing suture removal following cleft palate, alveolar ridge, or lip surgery. The study will include 60 children aged 6 months to 3 years, randomly assigned to one of three intervention groups. The primary objectives are to compare time to achieve adequate sedation (Modified Ramsay Sedation Scale 2-3), surgeon-rated ease of surgical procedure, and time to discharge readiness (Modified Aldrete Score ≥9). Secondary outcomes include baseline child behavior, response to drug administration, depth of sedation, response to separation from parents, and parental satisfaction, as well as monitoring of perioperative complications and vital signs. All study medications are approved and commonly used in pediatric anesthesia. The trial will be conducted using non-invasive monitoring, with intravenous access established only in case of emergency interventions. Findings from this study are expected to provide evidence to optimize pediatric sedation protocols for minor surgical procedures.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 6 months
Maximum Age: 3
Healthy Volunteers: f
View:

• Age 6 months to 3 years

• Scheduled for suture removal after surgery for congenital cleft of the palate, alveolar ridge, or lip

• American Society of Anesthesiologists (ASA) physical status I or II

• Written informed consent obtained from parents or legal guardians

• Slovene-speaking family to ensure understanding and compliance

• No contraindications to the use of study medications

Locations
Other Locations
Slovenia
Department of Maxillofacial and Oral Surgery, University Medical Centre Ljubljana
RECRUITING
Ljubljana
Contact Information
Primary
Liljana Markova, MD, PhD
liljana.markova@kclj.si
00 386 40 802 662
Backup
Eleonora Ivanova, MD
eleonora.ivanova@kclj.si
00 386 031 289 803
Time Frame
Start Date: 2025-09-01
Estimated Completion Date: 2029-01
Participants
Target number of participants: 60
Treatments
Active_comparator: Intramuscular Ketamine
Participants assigned to this arm will receive intramuscular ketamine at a dose of 4 mg/kg body weight for analgosedation during suture removal after surgery for congenital clefts. In addition, glycopyrrolate 4 mcg/kg will be administered intramuscularly to reduce salivation. This arm represents the control group, following the established clinical protocol.
Experimental: Intranasal Nalbuphine
Participants assigned to this arm will receive intranasal nalbuphine at a dose of 0.5 mg/kg body weight, administered using a mucosal atomizer device (MAD), for analgosedation during suture removal after cleft surgery. This intervention will be evaluated for its effectiveness, ease of administration, and safety compared with intramuscular ketamine.
Experimental: Intranasal Dexmedetomidine
Participants assigned to this arm will receive intranasal dexmedetomidine at a dose of 3 mcg/kg body weight, administered using a mucosal atomizer device (MAD), for analgosedation during suture removal after cleft surgery. The intervention will be evaluated for sedation depth, response to separation from parents, and overall procedural ease compared with other sedative agents.
Related Therapeutic Areas
Sponsors
Leads: University Medical Centre Ljubljana

This content was sourced from clinicaltrials.gov