Theresa Ray1, Joseph D Tobias2. 1. University of Missouri School of Medicine, Columbia, MO. 2. Division of Pediatric Anesthesiology, Department of Anesthesiology, University of Missouri School of Medicine, Columbia, MO; Department of Pediatrics, Russell and Mary Shelden Chair in Pediatric Intensive Care Medicine, University of Missouri School of Medicine, Columbia, MO. Electronic address: tobiasj@health.missouri.edu.
Abstract
STUDY OBJECTIVE: To assess the efficacy of dexmedetomidine in providing sedation during electroencephalographic (EEG) analysis in children with autism, seizure disorders, or pervasive developmental disorders (PDDs). DESIGN: Retrospective chart review. SETTING: University medical center. MEASUREMENTS: The charts of 42 children, aged two to 11 years, who received dexmedetomidine for sedation during EEG analysis, were studied. Information collected included route of administration of dexmedetomidine (oral and/or intravenous [i.v.]), loading dose, and infusion rate. Heart rate, blood pressure, respiratory rate, and level of sedation were monitored every 5 minutes, and oxygen saturation was monitored continuously during the procedure. Interventions (administration of fluid or use of an anticholinergic agent) for hypotension or bradycardia were identified. MAIN RESULTS: 18 children received oral dexmedetomidine (range, 2.9-4.4 microg/kg) before placement of an i.v.. Forty patients received an i.v. loading dose of dexmedetomidine (2.1 +/- 0.8 microg/kg), which was given in increments of 0.5 to one microg/kg every three to 5 minutes until a sedation score of 3 to 4 was achieved. Effective sedation was eventually achieved in all patients. An i.v. infusion of dexmedetomidine was started (1.5 +/- 0.2 microg kg(-1) hr(-1)) in all patients. During performance of the EEG, adjustments in the infusion rate (increase or decrease) or additional bolus doses were necessary in 25 patients. No significant hemodynamic or respiratory effects were noted. CONCLUSIONS: Dexmedetomidine provides effective sedation during EEG analysis in children with autism or PDD.
STUDY OBJECTIVE: To assess the efficacy of dexmedetomidine in providing sedation during electroencephalographic (EEG) analysis in children with autism, seizure disorders, or pervasive developmental disorders (PDDs). DESIGN: Retrospective chart review. SETTING: University medical center. MEASUREMENTS: The charts of 42 children, aged two to 11 years, who received dexmedetomidine for sedation during EEG analysis, were studied. Information collected included route of administration of dexmedetomidine (oral and/or intravenous [i.v.]), loading dose, and infusion rate. Heart rate, blood pressure, respiratory rate, and level of sedation were monitored every 5 minutes, and oxygen saturation was monitored continuously during the procedure. Interventions (administration of fluid or use of an anticholinergic agent) for hypotension or bradycardia were identified. MAIN RESULTS: 18 children received oral dexmedetomidine (range, 2.9-4.4 microg/kg) before placement of an i.v.. Forty patients received an i.v. loading dose of dexmedetomidine (2.1 +/- 0.8 microg/kg), which was given in increments of 0.5 to one microg/kg every three to 5 minutes until a sedation score of 3 to 4 was achieved. Effective sedation was eventually achieved in all patients. An i.v. infusion of dexmedetomidine was started (1.5 +/- 0.2 microg kg(-1) hr(-1)) in all patients. During performance of the EEG, adjustments in the infusion rate (increase or decrease) or additional bolus doses were necessary in 25 patients. No significant hemodynamic or respiratory effects were noted. CONCLUSIONS:Dexmedetomidine provides effective sedation during EEG analysis in children with autism or PDD.
Authors: Bi Lian Li; Vivian Man-Ying Yuen; Na Zhang; Huan Huan Zhang; Jun Xiang Huang; Si Yuan Yang; Jeffery W Miller; Xing Rong Song Journal: J Autism Dev Disord Date: 2019-09