Intranasal dexmedetomidine: the ideal drug for sedation in the pediatric echo lab? Cardiol Young 2022 Apr;32(4):545-549
Date
07/24/2021Pubmed ID
34294190DOI
10.1017/S1047951121002493Scopus ID
2-s2.0-85111121182 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
BACKGROUND: Intranasal dexmedetomidine is an attractive option for procedural sedation in pediatrics due to ease of administration and its relatively short half-life. This study sought to compare the safety and efficacy of intranasal dexmedetomidine to a historical cohort of pediatric patients sedated using chloral hydrate in a pediatric echo lab.
METHODS: Chart review was performed to compare patients sedated between September, 2017 and October, 2019 using chloral hydrate and intranasal dexmedetomidine. Vital signs, time to sedation, duration of sedation, need for second dose of medication, rate of failed sedation, and impact on vital signs were compared between groups. Subgroup analysis was performed for those with complex and cyanotic heart disease.
RESULTS: Chloral hydrate was used in 356 patients and intranasal dexmedetomidine in 376. Patient age, complexity of heart disease, and duration of sedation were similar. Rates of failed sedation were very low and similar. Average heart rate and minimum heart rate were lower for those receiving intranasal dexmedetomidine than chloral hydrate. Impact on vital signs was similar for those with complex and cyanotic heart disease. No adverse events occurred in either group.
CONCLUSIONS: Sedation with intranasal dexmedetomidine is comparable to chloral hydrate in regards to safety and efficacy for children requiring echocardiography. Consistent with the mechanism of action, patients receiving intranasal dexmedetomidine have a lower heart rate without morbidity.
Author List
Saudek DE, Walbergh D, Bartz P, Shreve S, Schaal A, Lavoie J, Frommelt PCAuthors
Peter J. Bartz MD Chief, Professor in the Pediatrics department at Medical College of WisconsinPeter C. Frommelt MD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
David Saudek MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
ChildChloral Hydrate
Cyanosis
Dexmedetomidine
Heart Diseases
Humans
Hypnotics and Sedatives
Infant
Pediatrics
Pharmaceutical Preparations