Intranasal dexmedetomidine is an effective sedative agent for electroencephalography in children

Abstract

Background: Intranasal dexmedetomidine (DEX), as a novel sedation method, has been used in many clinical examinations of infants and children. However, the safety and efficacy of this method for electroencephalography (EEG) in children is limited. In this study, we performed a large-scale clinical case analysis of patients who received this sedation method. The purpose of this study was to evaluate the safety and efficacy of intranasal DEX for sedation in children during EEG. Methods: This was a retrospective study. The inclusion criteria were children who underwent EEG from October 2016 to October 2018 at the Children's Hospital affiliated with Chongqing Medical University. All the children received 2.5 μg•kg − 1 of intranasal DEX for sedation during the procedure. We used the Modified Observer Assessment of Alertness/Sedation Scale (MOAA/S) and the Modified Aldrete score (MAS) to evaluate the effects of the treatment on sedation and resuscitation. The sex, age, weight, American Society of Anesthesiologists physical status (ASAPS), vital signs, sedation onset and recovery times, sedation success rate, and adverse patient events were recorded. Results: A total of 3475 cases were collected and analysed in this study. The success rate of the initial dose was 87.0% (3024/3475 cases), and the success rate of intranasal sedation rescue was 60.8% (274/451 cases). The median sedation onset time was 19 mins (IQR: 17-22 min), and the sedation recovery time was 41 mins (IQR: 36-47 min). The total incidence of adverse events was 0.95% (33/3475 cases), and no serious adverse events occurred. Conclusions: Intranasal DEX (2.5 μg•kg − 1) can be safely and effectively used for EEG sedation in children.

Comparison of oral triclofos and intranasal midazolam and dexmedetomidine for sedation in children undergoing magnetic resonance imaging (MRI): an open-label, three-arm, randomized trial

“…It has been reported to be non-noxious to the nasal mucosa in different studies [24,25]. But in the present study, nasal discomfort was observed in 2 children with IND administration, which could be due to administration of the drug by a syringe and would have been best avoided with the use of a mucosal atomizer device [28], whereas a success rate of 87% was reported in a similar study using IND at a dose of 2.5 µg/kg [29]. In a recent systematic review, the success rate of IND was shown to vary from 30 to 100% depending on the dose of the drug and type of procedures requiring sedation [10].…”

Effects of intranasal and intramuscular dexmedetomidine in cats receiving total intravenous propofol anesthesia

“…Contrastingly, most cats had deep sedation in the IM group 5-10 min after drug administration. Notably, IN administration of anesthetic drugs has variable peak sedation times in different species [6,12]. The onset of IN dexmedetomidine in humans has been reported at 45 min after administration [14,15], whereas 6.3 ± 3.3 min in dogs [6].…”

“…This represents a convenient, simple, and noninvasive administration approach [8,10]. Recently, IN dexmedetomidine has been applied in children [5,[11][12][13]. The drug delivery effectiveness through the IN route that targets the brain has been previously shown in humans [14,15] and dogs [6,8,10].…”

COVID-19: consideraciones en el manejo de la vía aérea en pacientes pediátricos

“…Tiene la gran ventaja de no desencadenar apnea, ni incrementar la secreción salival; su repercusión en el calibre de las vías aéreas es mínima; 10,11 mayor con propofol, midazolam y halogenados. 12,13,14 La dosis sugerida es de 1.5 -2 mcg por kg de peso intravenoso, a pasar lentamente, siempre con monitoreo continuo, tipo I como mínimo, y aporte de oxígeno. Es importante recordar que no es recomendable la administración en bolo intravenoso.…”