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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Related to that we have found it ineffective for kids more than kg… have you found the same?

Intranasal Dexmedetomidine

We excluded subjects who were younger than 6 months of age, had a history of cardiac disease, had an ASA score of III to IV, and subjects who had to undergo procedures that would be invasive or painful. Repeated measurements data were analyzed using the paired t -test, and binary data were analyzed using Chi-squared test. J Int Med Dexmevetomidine.

The success of magnetic resonance imaging MRI as a diagnostic tool has led to its increased use in patients of all age groups; however, children undergoing MRI often require dexmedeto,idine because the magnetic field creates a sound of a very high decibel and to minimize intraasal artifact. Within 15 min of cannulation, the patients underwent MRI. In addition, the use of the nasal MAD mucosal atomization device has allowed quick and even administration of the drug.

A randomised comparison of two intranasal dexmedetomidine doses for premedication in children. Various drugs are available for premedication, with midazolam being the most commonly used.

The difference in onset time was statistically significant with early onset in midazolam. 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. Additional data suggest that when compared to intravenously administrated DEX, IN DEX has a significantly lower risk of respiratory depression and hemodynamic changes. How do I use the MAD device?


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Intranasal Dexmedetomidine as a Sedative for Pediatric Procedural Sedation

A comparative evaluation of intranasal dexmedetomidine and intranasal midazolam for premedication in children: Median sedation scores for Groups M and D were 4 and 3, respectively [ Figure 4 ].

Dexmefetomidine patients received intravenous propofol as an induction and maintenance agent for MRI. Please review our privacy policy. The level of sedation and vital signs were documented every 3 to 5 minutes. Comparison of mean systolic blood pressure between the two groups.

Intranasal Dexmedetomidine as a Sedative for Pediatric Procedural Sedation

However, few studies have reported on the intranasal use of dexmedetomidine in radiological procedures. Buccal Administration of Dexmedetomidine as a Preanesthetic in Children. Evidence supports the use of dexmedetomidine for sedation in mechanically ventilated adult patients.

Our dosing is very similar: Thanks for the interesting topic. This study seeks to evaluate the efficacy and safety of intranasal IN dexmedetomidine as a sedative medication for non-invasive procedural sedation.

We have not used IN Dex routinely on older children we will typically put an IV in if you are older than 4 or 5 and really appreciate your experience.

This database was intended to track and study the observed events of sedative medications Table 2 and our current practice. Contrastingly, dexmedetomidine does not cause any transient nasal burning or irritation, paradoxical reaction, hiccups, and respiratory depression.

Dexmedetomidine has a much shorter half life than clonidine hours vs. National Center for Biotechnology InformationU.

Comparison of the nasal and sublingual routes. Intranasal dexmedetomudine vs midazolam for premedication in children undergoing complete dental rehabilitation: J Anaesthesiol Clin Pharmacol. The non-DEX cohort had more subjects in the deep sedation cohort, subjects Premedication facilitates overcoming these difficulties, with midazolam being the most commonly used agent.

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


We observed successful parental separation dexmedetoomidine Premedication with intranasal dexmedetomidine, midazolam and ketamine for children undergoing bone marrow biopsy and aspirate. Due to this demand, the role of pediatric critical care providers, hospitalists, and emergency physicians has also expanded to include PSA.

Discussion Premedication is required to alleviate anxiety and fear, allow smooth separation from parents, and allow easy acceptance of needle prick for intravenous cannulation and anesthesia induction.

Intranasal Dexmedetomidine | Pediatric Sedation Blog

This prospective, randomized trial compared intranasal midazolam dexmedetomidlne intranasal dexmedetomidine as premedication for children scheduled for brain MRI. On the day of the non-invasive procedure, the physician providing the sedation evaluated each subject. A comparison of intranasal dexmedetomidine and oral midazolam for premedication in pediatric anesthesia: Intranasal application is a relatively noninvasive, convenient, and easy route of administration and results in a faster onset of action as well as reduces first-pass metabolism.

Discussion There are an increasing number of published reports describing the use of DEX; however, there is little agreement regarding the dose and route of administration. Dexmedetomidine has been extensively studied intranasally in both children and adults.

Comparison of two different intranasal doses of dexmedetomidine in children for magnetic resonance imaging sedation. On the basis of this information, we have used intranasal dexmedetomidine as a premedication in a number of patients.

National Center for Biotechnology InformationU. A comparison of four routes of administration. Clinical uses of dexmedetomidine in pediatric populations. Further research using IN DEX would benefit from a large multicenter, which could include investigation of the effect of procedure type on success.