Background: Preoperative anxiety is frequently observed among paediatric patients due to separation from parents, unfamiliar hospital surroundings, and anticipation of pain. Such anxiety is linked to several adverse outcomes, including distress during recovery and behavioral disturbances like nightmares, bedwetting, and eating issues. Managing this anxiety is a crucial responsibility for anaesthesiologists. Nebulised dexmedetomidine has emerged as a promising non-invasive option for premedication in children. However, its optimal dosing remains under investigation. This study compares the efficacy of two doses—2 mcg/kg and 3 mcg/kg—of nebulised dexmedetomidine in paediatric premedication.

Methodology: In this prospective, randomised trial, 78 children aged 1–8 years were assigned to two groups. Group A received 2 mcg/kg and Group B received 3 mcg/kg of nebulised dexmedetomidine preoperatively. Thirty minutes post-nebulisation, Parental Separation Anxiety Scale (PSAS) scores were recorded. Mask Acceptance Scores (MAS) were assessed before anaesthesia induction. All participants underwent general anaesthesia. Hemodynamic parameters, sedation levels, and emergence agitation were also evaluated and compared using standard statistical tests. A p-value <0.05 was considered statistically significant.

Results: Group B demonstrated significantly improved parental separation (p<0.003) and mask acceptance (p<0.014) compared to Group A. Hemodynamic stability was maintained in both groups without statistically significant differences. No adverse events were observed during the perioperative period.

Conclusion: Nebulised dexmedetomidine at a dose of 3 mcg/kg is more effective than 2 mcg/kg in improving parental separation and mask acceptance in paediatric patients, without compromising safety or hemodynamic stability.