Predictors of pediatric sedation failure with initial dose of intranasal dexmedetomidine and oral midazolam

Cui, Yu; Gong, Tianqing; Mu, Qixia; Wu, Qunying; Kang, Lu; Chen, Qin; He, Yani

doi:10.1038/s41390-023-02758-0

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…Cossovel et al [19] interestingly investigate the difference between two approach, combination of intranasal ketamine and intranasal dexmedetomidine compare with the the combination intranasal dexmedetomidine and oral midazolam. Compared with other studies in literature, the results look controversial, probably because of limits and confounding factors in the design of the studies [20][21][22]. Prospective studies are needed.…”

Section: Anesthesiology 1-sedation 1-sedationmentioning

confidence: 92%

Advances for pediatricians in 2022: allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology

Caffarelli,

Santamaria,

Piro

et al. 2023

Ital J Pediatr

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The last year saw intensive efforts to advance knowledge in pediatric medicine. This review highlights important publications that have been issued in the Italian Journal of Pediatrics in 2022. We have chosen papers in the fields of allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology. Novel valuable developments in epidemiology, pathophysiology, prevention, diagnosis and treatment that can rapidly change the approach to diseases in childhood have been included and discussed.

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Section: Anesthesiology 1-sedation 1-sedationmentioning

confidence: 92%

Advances for pediatricians in 2022: allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology

Caffarelli,

Santamaria,

Piro

et al. 2023

Ital J Pediatr

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Four-year review of safe and effective procedural sedation in neonates and young infants

Cui,

Tang,

et al. 2024

Front. Pharmacol.

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ObjectivesNewborns and small infants are unable to cooperate actively during diagnostic procedures; therefore, sedation is often employee to maintain immobilization and obtain high-quality images. However, these procedures are often indicated in sick, vulnerable, or hemodynamically unstable neonates and young infants, which raises the associated risks of sedation. This study summarizes our 4-year of experience with safe and effective procedural sedation in this vulnerable population.Study designThis retrospective study analyzed data on neonates and young infants who underwent non-painful diagnostic procedures from December 2019 to November 2023. Patients were categorized into the neonate (aged≦ 28 days) and the young infant (29 days ≦ aged ≦ 90 days) groups.ResultsNon-pharmacological strategies, including sleeping naturally, swaddling/facilitated tucking, non-nutritive sucking, and skin-to-skin care, can achieve a success rate for sedation about 98.4%. In terms of pharmacological methods, our institution primarily utilizes chloral hydrate for procedural sedation in neonates and young infants undergoing non-painful diagnostic procedures. Midazolam serves as an alternative sedative. Chloral hydrate alone demonstrated a 92.5% success rate on the first attempt, compared to midazolam alone, with an 85.11% success rate. Neonates experienced a higher incidence of adverse events during sedation compared to young infants.ConclusionThis study reviews our 4-year experience with procedural sedation in neonates and young infants. Chloral hydrate demonstrated a high degree of safety and efficacy in this population. However, supervision by skilled medical personnel and extended observation is required. In our institution, the experience with midazolam is limited in this population, and further research is warranted to establish its safety and efficacy. Non-pharmacological strategies can achieve an acceptable rate of sedation success, which can be used based on patient’s tolerance.

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Predictors of pediatric sedation failure with initial dose of intranasal dexmedetomidine and oral midazolam

Cited by 2 publications

References 22 publications

Advances for pediatricians in 2022: allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology

Advances for pediatricians in 2022: allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology

Four-year review of safe and effective procedural sedation in neonates and young infants

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