Intranasal Dexmedetomidine May be a Worthy Alternative for Sedation in Preterm Infants: A Retrospective Single Center Study

Abstract

Introduction: Neonatal intensive care units are a highly stressful environment exposing immature infants to pain and non-pain related stress. Our aim was to assess intranasal dexmedetomidine as sedation during stressful and painful episodes in VLBW infants.Methods: Data were retrospectively collected from medical charts of infants before and after routine use of dexmedetomidine for sedation in a single centre. Primary outcomes were N-PASS scores after sedation and respiratory support parameters. Secondary outcomes included hemodynamic and respiratory adverse effects, length of hospital stay, days to full feeding, and neonatal morbidities. A multivariate logistic regression model was used to assess the effect of several variables on a dependent variable, and the association with intranasal dexmedetomidine administration.Results: Sixty-three preterm very low birth weight infants were included. Birth weight and gestational were comparable between the groups. (28.3 vs 29.2, and 1076 vs 1218gr respectively). Infants were treated by intravenous fentanyl or midazolam, and intranasal dexmedetomidine. N-Pass scores were comparable before and after sedation between the groups. (2.72 and 2.54 before and 2.24 and 2.45 after). Rates of adverse effects and major neonatal morbidities were comparable between groups. There was statistically significant, although mild reduced use of adjunctive midazolam in infants treated with intranasal dexmedetomidine. Conclusions:Our data indicate that in our cohort, intranasal dexmedetomidine served as a worthy option for sedation of preterm VLBW infants.