High Dose Dexmedetomidine: Effective as a Sole Agent Sedation for Children Undergoing MRI

Objective. To determine the efficacy and safety of high dose dexmedetomidine as a sole sedative agent for MRI. We report our institution’s experience. Design. A retrospective institutional review of dexmedetomidine usage for pediatric MRI over 5.5 years. Protocol included a dexmedetomidine bolus of...

Full description

Saved in:
Bibliographic Details
Main Authors: Sheikh Sohail Ahmed, Tamara Unland, James E. Slaven, Mara E. Nitu
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:International Journal of Pediatrics
Online Access:http://dx.doi.org/10.1155/2015/397372
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832567139266985984
author Sheikh Sohail Ahmed
Tamara Unland
James E. Slaven
Mara E. Nitu
author_facet Sheikh Sohail Ahmed
Tamara Unland
James E. Slaven
Mara E. Nitu
author_sort Sheikh Sohail Ahmed
collection DOAJ
description Objective. To determine the efficacy and safety of high dose dexmedetomidine as a sole sedative agent for MRI. We report our institution’s experience. Design. A retrospective institutional review of dexmedetomidine usage for pediatric MRI over 5.5 years. Protocol included a dexmedetomidine bolus of 2 μg/kg intravenously over ten minutes followed by 1 μg/kg/hr infusion. 544 patients received high dose dexmedetomidine for MRI. A second bolus was used in 103 (18.9%) patients. 117 (21.5%) required additional medications. Efficacy, side effects, and use of additional medicines to complete the MRI were reviewed. Data was analyzed using Student’s t-test, Fisher’s exact test, and Analysis of Variance (ANOVA). Main Results. Dexmedetomidine infusion was associated with bradycardia (3.9%) and hypotension (18.4%). None of the patients required any intervention. Vital signs were not significantly different among the subgroup of patients receiving one or two boluses of dexmedetomidine or additional medications. Procedure time was significantly shorter in the group receiving only one dexmedetomidine bolus and increased with second bolus or additional medications (P<0.0001). Discharge time was longer for children experiencing bradycardia (P=0.0012). Conclusion. High dose Dexmedetomidine was effective in 78.5% of cases; 21.5% of patients required additional medications. Side effects occurred in approximately 25% of cases, resolving spontaneously.
format Article
id doaj-art-ee12286a252049309a9fd9cdcc64dc62
institution Kabale University
issn 1687-9740
1687-9759
language English
publishDate 2015-01-01
publisher Wiley
record_format Article
series International Journal of Pediatrics
spelling doaj-art-ee12286a252049309a9fd9cdcc64dc622025-02-03T01:02:25ZengWileyInternational Journal of Pediatrics1687-97401687-97592015-01-01201510.1155/2015/397372397372High Dose Dexmedetomidine: Effective as a Sole Agent Sedation for Children Undergoing MRISheikh Sohail Ahmed0Tamara Unland1James E. Slaven2Mara E. Nitu3Department of Pediatrics, Section of Pediatric Critical Care, Pediatric Sedation and Cardiovascular Intensive Care Unit, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, 705 Riley Hospital Drive RI 4909 4B, Indianapolis, IN 46202, USADepartment of Pediatrics, Pediatric Procedural Sedation, Riley Hospital for Children at IU Health North, 11700 N. Meridian Street, Carmel, IN 46032, USADepartment of Biostatistics, Indiana University School of Medicine, 410 W. 10th Street, Suite 3000, Indianapolis, IN 46202, USADepartment of Pediatrics, Section of Pediatric Critical Care, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, 705 Riley Hospital Drive RI 4909 4B, Indianapolis, IN 46202, USAObjective. To determine the efficacy and safety of high dose dexmedetomidine as a sole sedative agent for MRI. We report our institution’s experience. Design. A retrospective institutional review of dexmedetomidine usage for pediatric MRI over 5.5 years. Protocol included a dexmedetomidine bolus of 2 μg/kg intravenously over ten minutes followed by 1 μg/kg/hr infusion. 544 patients received high dose dexmedetomidine for MRI. A second bolus was used in 103 (18.9%) patients. 117 (21.5%) required additional medications. Efficacy, side effects, and use of additional medicines to complete the MRI were reviewed. Data was analyzed using Student’s t-test, Fisher’s exact test, and Analysis of Variance (ANOVA). Main Results. Dexmedetomidine infusion was associated with bradycardia (3.9%) and hypotension (18.4%). None of the patients required any intervention. Vital signs were not significantly different among the subgroup of patients receiving one or two boluses of dexmedetomidine or additional medications. Procedure time was significantly shorter in the group receiving only one dexmedetomidine bolus and increased with second bolus or additional medications (P<0.0001). Discharge time was longer for children experiencing bradycardia (P=0.0012). Conclusion. High dose Dexmedetomidine was effective in 78.5% of cases; 21.5% of patients required additional medications. Side effects occurred in approximately 25% of cases, resolving spontaneously.http://dx.doi.org/10.1155/2015/397372
spellingShingle Sheikh Sohail Ahmed
Tamara Unland
James E. Slaven
Mara E. Nitu
High Dose Dexmedetomidine: Effective as a Sole Agent Sedation for Children Undergoing MRI
International Journal of Pediatrics
title High Dose Dexmedetomidine: Effective as a Sole Agent Sedation for Children Undergoing MRI
title_full High Dose Dexmedetomidine: Effective as a Sole Agent Sedation for Children Undergoing MRI
title_fullStr High Dose Dexmedetomidine: Effective as a Sole Agent Sedation for Children Undergoing MRI
title_full_unstemmed High Dose Dexmedetomidine: Effective as a Sole Agent Sedation for Children Undergoing MRI
title_short High Dose Dexmedetomidine: Effective as a Sole Agent Sedation for Children Undergoing MRI
title_sort high dose dexmedetomidine effective as a sole agent sedation for children undergoing mri
url http://dx.doi.org/10.1155/2015/397372
work_keys_str_mv AT sheikhsohailahmed highdosedexmedetomidineeffectiveasasoleagentsedationforchildrenundergoingmri
AT tamaraunland highdosedexmedetomidineeffectiveasasoleagentsedationforchildrenundergoingmri
AT jameseslaven highdosedexmedetomidineeffectiveasasoleagentsedationforchildrenundergoingmri
AT maraenitu highdosedexmedetomidineeffectiveasasoleagentsedationforchildrenundergoingmri