April 25, 2020

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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None of the children in both groups had untoward complications, such as bradycardia, hypotension, hypertension, and respiratory depression, after premedication.

Intranasal Dexmedetomidine as a Sedative for Pediatric Procedural Sedation

Onset occurred in minutes with a peak effect at 90 minutes. Comparison of two different intranasal doses of dexmedetomidine in children for magnetic resonance imaging sedation. Optimal timing for the administration of intranasal dexmedetomidine for premedication in children. J Pediatr Pharmacol Ther.

Within 15 min of cannulation, the patients underwent MRI. It acts on the locus coeruleus and produces an unusually cooperative form of sedation, in imtranasal the patient is calmly and easily aroused from sleep to wakefulness and subsequently quickly falls back asleep when not stimulated, which is similar to natural sleep.

Various drugs are available for premedication, with midazolam being the most commonly used.

Financial support and sponsorship Nil. Sedation nurses also documented sedative medications used for the procedure, level of sedation Table 1and observed dexmdetomidine.


Premedication with midazolam in children. This practice is gaining more popularity amongst sedation providers outside of the operating room due to a decrease in emotional stress in children that is related to intrwnasal IN administration route.

A successful sedation with IN DEX was determined by completion of the non-invasive study without any additional sedative medications required to maintain subject’s sedation. In addition, the use of the nasal MAD mucosal atomization device has allowed quick and even administration of the drug. All subjects were informed about the database and were given the opportunity to opt-out from being included before PSA initiation.

On the basis of this information, we have used intranasal dexmedetomidine as a premedication in a number of patients.

Intranasal Dexmedetomidine

Dexmedetomidine has been extensively studied intranasally in both children and adults. The baseline HR was comparable between the groups [ Figure 1 ].

Subjects 6 months to 18 years of age undergoing non-invasive elective procedures were included. Median sedation scores for Groups M and D were 4 and 3, respectively [ Figure 4 ].

On the day of MRI, the nil by mouth status was confirmed, and parental consent was obtained. However, midazolam is associated with the risk of respiratory depression and has no analgesic action. The non-DEX cohort had more subjects in the deep sedation cohort, subjects For induction, an intravenous bolus of 0. A comparative evaluation of intranasal dexmedetomidine, midazolam and ketamin for their sedative and analgesic properties: In another study by Mostafa and Morsy comparing the use of dexmedetomidine, midazolam, and ibtranasal as intranasal premedication, the percentage of children who achieved child—parent separation score Grade 1 was Investigations conducted by Yuen et al.


Intranasal Dexmedetomidine as a Sedative for Pediatric Procedural Sedation

J Anaesthesiol Clin Pharmacol. Time of induction was noted, and whether parental separation at the time of induction was successful was recorded. However, midazolam is associated with respiratory depression and an increased incidence of adverse postoperative behavioral changes, hiccups, and paradoxical reactions.

Open in a separate window. Comparison of the nasal and sublingual routes. Please review our privacy policy. Given this dose, this child calmed and fell asleep in the stretcher within 20 minutes. Dexmedetomidine is known to decrease sympathetic outflow and circulating catecholamine levels. National Center for Biotechnology InformationU. Use in MRI Evidence supports the use of dexmedetomidine for sedation in mechanically ventilated adult patients.

Similar findings regarding side effects were noted in other studies. Transmucosal administration of midazolam for premedication of pediatric patients. The plan of care was then formulated and discussed with the family.