Dexmedetomidine Offers an Option for Safe and Effective Sedation for Nuclear Medicine Imaging in Children

Mason, Keira P.; Robinson, Fay; Fontaine, Paulette J.; Prescilla, Randy

doi:10.1148/radiol.13121232

Cited by 58 publications

(42 citation statements)

References 38 publications

(55 reference statements)

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“…Many studies have revealed that the sedative dose of DEX can create a state of natural sleep and it can be safely used in children without inducing respiratory depression [20]. Intranasal DEX is relatively easy and convenient, and it also reduces first-pass metabolism and has been successfully used for sedation [11].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing cataract surgery with sevoflurane

Lin

Chen

Huang

et al. 2016

Journal of Clinical Anesthesia

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Section: Discussionmentioning

confidence: 99%

Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing cataract surgery with sevoflurane

Lin

Chen

Huang

et al. 2016

Journal of Clinical Anesthesia

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“…[13][14][15] It has been successfully administered via the IV and intramuscular routes for pediatric radiologic imaging. 7,[16][17][18] To date, however, the literature does not describe sedation via the intranasal route with aerosolized DEX for pediatric CT. 5,16 The intranasal route has been described for perioperative anxiolysis. [19][20][21][22] In adults, there is up to 83% bioavailability of intranasal DEX, with onset in 30-45 minutes.…”

Section: Discussionmentioning

confidence: 99%

Intranasal Dexmedetomidine for Sedation for Pediatric Computed Tomography Imaging

Filho

Robinson

Carvalho

et al. 2015

The Journal of Pediatrics

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“…On arrival at the PACU, vital signs (HR, non-invasive blood pressure, RR, SpO 2 , temperature), RSS, and VAS were monitored every 5 min for the first 20 min, then every 10 min for the rest of the time until the patients were discharged to the wards (Aldrete Score ≥ 9) (Mason et al, 2013). Surgeon satisfaction was assessed as follows 24 h after burr-hole surgery: 1, extremely dissatisfied; 2, not satisfied but able to manage; 3, satisfied; 4, extremely satisfied); patients were visited to assess satisfaction on a 7-point Likert verbal rating scale (Bagchi et al, 2014).…”

Section: Methodsmentioning

confidence: 99%

The Safety and Efficacy of Dexmedetomidine vs. Sufentanil in Monitored Anesthesia Care during Burr-Hole Surgery for Chronic Subdural Hematoma: A Retrospective Clinical Trial

et al. 2016

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Background: Chronic subdural hematoma (CSDH) is a very common clinical emergency encountered in neurosurgery. While both general anesthesia (GA) and monitored anesthesia care (MAC) can be used during CSDH surgery, MAC is the preferred choice among surgeons. Further, while dexmedetomidine (DEX) is reportedly a safe and effective agent for many diagnostic and therapeutic procedures, there have been no trials to evaluate the safety and efficacy of DEX vs. sufentanil in CSDH surgery.Objective: To evaluate the safety and efficacy of DEX vs. sufentanil in MAC during burr-hole surgery for CSDH.Methods: In all, 215 fifteen patients underwent burr-hole surgery for CSDH with MAC and were divided into three groups: Group D1 (n = 67, DEX infusion at 0.5 μg·kg−1 for 10 min), Group D2 (n = 75, DEX infusion at 1 μg·kg−1 for 10 min), and Group S (n = 73, sufentanil infusion 0.3 μg·kg−1 for 10 min). Ramsay sedation scale (RSS) of all three groups was maintained at 3. Anesthesia onset time, total number of intraoperative patient movements, hemodynamics, total cumulative dose of DEX, time to first dose and amount of rescue midazolam or fentanyl, percentage of patients converted to alternative sedative or anesthetic therapy, postoperative recovery time, adverse events, and patient and surgeon satisfaction scores were recorded.Results: The anesthesia onset time was significantly less in group D2 (17.36 ± 4.23 vs. 13.42 ± 2.12 vs. 15.98 ± 4.58 min, respectively, for D1, D2, S; P < 0.001). More patients in groups D1 and S required rescue midazolam to achieve RSS = 3 (74.63 vs. 42.67 vs. 71.23%, respectively, for D1, D2, S; P < 0.001). However, the total dose of rescue midazolam was significantly higher in group D1 (2.8 ± 0.3 vs. 1.9 ± 0.3 vs. 2.0 ± 0.4 mg, respectively, for D1, D2, S; P < 0.001). The time to first dose of rescue midazolam was significantly longer in group D2 (17.32 ± 4.47 vs. 23.56 ± 5.36 vs. 16.55 ± 4.91 min, respectively, for D1, D2, S; P < 0.001). Significantly fewer patients in groups S and D2 required rescue fentanyl to relieve pain (62.69 vs. 21.33 vs. 27.40%, respectively, for D1, D2, S; P < 0.001). Additionally, total dose of rescue fentanyl in group D1 group was significantly higher (212.5 ± 43.6 vs. 107.2 ± 35.9 vs. 98.6 ± 32.2 μg, respectively, for D1, D2, S; P < 0.001). Total number of patient movements during the burr-hole surgery was higher in groups D1 and S (47.76 vs. 20.00 vs. 47.95%, respectively, for D1, D2, S; P < 0.001). Four patients in D1 and five in S converted to propofol. The time to recovery for discharge from the PACU was significantly shorter in group D2 (16.24 ± 4.15 vs. 12.48 ± 3.29 vs. 15.91 ± 3.66 min, respectively, for D1, D2, S; P < 0.001). Results from the patient and surgeon satisfaction scores showed significant differences favoring group D2 (P < 0.05). More patients in groups D1 and S showed higher levels of the overall incidence of tachycardia and hypertension, and required higher doses of urapidil and esmolol (P < 0.05). Six patients experienced respiratory depression in group S...

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Dexmedetomidine Offers an Option for Safe and Effective Sedation for Nuclear Medicine Imaging in Children

Cited by 58 publications

References 38 publications

Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing cataract surgery with sevoflurane

Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing cataract surgery with sevoflurane

Intranasal Dexmedetomidine for Sedation for Pediatric Computed Tomography Imaging

The Safety and Efficacy of Dexmedetomidine vs. Sufentanil in Monitored Anesthesia Care during Burr-Hole Surgery for Chronic Subdural Hematoma: A Retrospective Clinical Trial

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