Comparison between intranasal dexmedetomidine and intranasal midazolam as premedication for brain magnetic resonance imaging in pediatric patients: A. Intranasal dexmedetomidine has been used an effective and safe alternative premedication to oral midazolam in children. At a dose of 2micrograms/kg. Background Intranasal dexmedetomidine, a well-tolerated and convenient treatment option, has been shown to induce a favorable.

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Intranasal Dexmedetomidine as a Sedative for Pediatric Procedural Sedation

Table 1 Demographic data. Premedication facilitates overcoming these difficulties, with midazolam being the most commonly used intranazal. Introduction The importance of procedural sedation and analgesia PSA for children undergoing procedures and imaging studies has led to an increase in demand for sedation outside of the operating room.

He was recovered in the PACU for an hour and was discharged. Our secondary objective was to evaluate the safety profile of IN DEX compared to well-established intravenous sedative medications i.

Intranasal Dexmedetomidine | Pediatric Sedation Blog

The baseline HR was comparable between the groups [ Figure 1 ]. Dexmedetomidine dexmedegomidine been extensively studied intranasally in both children and adults. Further Study All of this is anecdotal and should be studied further. Phillips, Thank you for this interesting blog. Table 2 Comparison of successful parental separation between the groups. Comparison of two different intranasal doses of dexmedetomidine in children for magnetic resonance imaging sedation.


Given this dose, this child calmed and dex,edetomidine asleep in the stretcher within 20 minutes. Conflicts of interest There are no conflicts of interest. The mean age and weight were 2. A subgroup analysis dexmedetomldine procedure times found no statistical difference in subjects who had received additional IN midazolam compared to those given IN DEX alone; however, the sample size lacked adequate power.

J Pediatr Pharmacol Ther. An alternative to benzodiazepines for premedication in children.

All of this is anecdotal and should be studied further. Subjects were contacted the night before the procedure and were given relevant instructions regarding when and where to arrive and fasting time. Median sedation scores for Groups M and D were 4 and 3, respectively [ Figure 4 ].

Contrastingly, dexmedetomidine does not cause any transient nasal burning or irritation, paradoxical reaction, hiccups, and respiratory depression. SpO 2HR, BP, and RR were noted at the time of induction, for every 5 min for the first 15 min and then for every 15 min until the end of brain MRI, which lasted for a maximum of 60 min. Methods This itranasal a prospective observational study, performed in our procedural suite, located at a tertiary medical center.

Optimal timing for the administration of intranasal dexmedetomidine for premedication in children.

It has been very beneficial for our practice. The mean age and weight of the non-DEX cohort was 3. Intranasao pediatric critical care physicians who are experienced in providing PSA outside of the operating room provided all PSA.

Results The demographic profile was comparable between the two groups [ Table dexmedetomirine ]. There has been increasing interest in the clinical application of dexmedetomidine in the pediatric population.


The patients were randomly allocated to two groups. All subjects were informed about the database and were given the opportunity to opt-out from being included before PSA initiation.

Dexmedetomidine is only available in an intravenous formulation; intravenous preparation has been used through oral, transmucosal, and intranasal routes.

A double blind RCT.

A double-blind, crossover assessment of the sedative and analgesic effects of intranasal dexmedetomidine. Sedation was considered successful when the patients were calm and sedated, were not crying and agitated, and allowed smooth induction.

Financial support and sponsorship Nil. This prospective, randomized trial compared intranasal midazolam with intranasal dexmedetomidine as premedication for children scheduled for brain MRI. Preanesthetic assessment included medical and surgical history; general and systemic examination; airway examination; and investigations, such as complete hemogram and renal function tests, conducted on an outpatient basis.

Footnotes Disclosure The authors declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria. However, midazolam is associated with respiratory depression and an increased incidence of adverse postoperative behavioral changes, hiccups, and paradoxical reactions. Preprocedural preparation of children scheduled for magnetic resonance imaging MRI is challenging.

High dose dexmedetomidine intrnasal the sole sedative for pediatric mri.

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