Intranasal Dexmedetomidine as Sedative for Non-Invasive Pediatric Diagnostic Procedures Outside Operating Room

Abstract

Background: Children often require sedation for long non-invasive diagnostic procedures. Dexmedetomidine is a highly selective alpha 2-adrenoceptor agonist with sedative, anxiolytic and analgesic properties. It mimics natural sleep and allows patients to easily arouse with minimal effects on respiration and airway patency. Objective: To assess the successful completion of pediatric non-invasive diagnostic procedures with intranasal dexmedetomidine as a sedative agent. Methods: Seventy-nine subjects of age six months to twelve years scheduled for non-invasive diagnostic procedures were included. Dexmedetomidine (4 mcg/kg) was administered intranasally 25 minutes before the scheduled time of procedure. A sedation score of two or above as per the MICHIGAN sedation scale was considered satisfactory for starting the procedure. Results: Seventy-four (95%) out of the seventy-nine subjects were successfully sedated with Intranasal dexmedetomidine (p<0.0001). The mean time and Standard deviation to achieve sedation was 18.9 ± 2.82 mins. The median time was 19 mins with a range from 15-25 minutes. Post anesthesia discharge time for Intranasal dexmedetomidine was 20 minutes with zero incidence of post procedure nausea and vomiting. Conclusions: Intranasal dexmedetomidine can be used as an alternative to General anesthesia for non-invasive diagnostic procedures outside operating room with less adverse effects in this cohort.