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Intranasal dexmedetomidine: the ideal drug for sedation in the pediatric echo lab?

Part of: Echocardiography

Published online by Cambridge University Press:  23 July 2021

David E Saudek Open the ORCID record for David E Saudek [Opens in a new window] ,
Deborah Walbergh ,
Peter Bartz ,
Sara Shreve ,
Amy Schaal ,
Julie Lavoie Open the ORCID record for Julie Lavoie [Opens in a new window]  and
Peter C Frommelt
David E Saudek*
Affiliation:
Medical College of Wisconsin, Milwaukee, Wisconsin, USA
Deborah Walbergh
Affiliation:
Children’s Hospital of Wisconsin, Milwaukee, Wisconsin, USA
Peter Bartz
Affiliation:
Medical College of Wisconsin, Milwaukee, Wisconsin, USA
Sara Shreve
Affiliation:
Children’s Hospital of Wisconsin, Milwaukee, Wisconsin, USA
Amy Schaal
Affiliation:
Children’s Hospital of Wisconsin, Milwaukee, Wisconsin, USA
Julie Lavoie
Affiliation:
Children’s Hospital of Wisconsin, Milwaukee, Wisconsin, USA
Peter C Frommelt
Affiliation:
Medical College of Wisconsin, Milwaukee, Wisconsin, USA
*
Author for correspondence: David Saudek, Children’s Wisconsin, 9000 W Wisconsin Ave, MilwaukeeWI 53226, USA. Tel/Fax: +1 (414) 266-2380. E-mail: dsaudek@chw.org
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Abstract

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.

Keywords

PediatricechocardiographyChloral hydratesedationdexmedetomidine
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 4 , April 2022 , pp. 545 - 549
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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