Dexmedetomidine for EEG sedation in children with behavioral disorders

Sfriso, Francesca; Bonardi, Claudia; Viaggi, Francesco; Sartori, Stefano; Boniver, Clementina; Martinolli, Francesco; Dalt, Liviana Da; Frigo, Anna Chiara; Mazza, Alessandro; Amigoni, Angela

doi:10.1111/ane.13293

Cited by 5 publications

(2 citation statements)

References 20 publications

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“…According to Sfriso et al [30], there wasn't any correlation between the total dose of DEX and adverse effects (intravenous DEX p = 0.3247; intranasal DEX p = 0.1504). Nevertheless, there is a statistically signi cant correlation between adverse events and chronic medications at home (p 0.0449).…”

Section: Discussionmentioning

confidence: 97%

Dexmedetomidine for Electroencephalogram in patients with behavioural disorders: a comparative study between intranasal and intravenous administration

Poletto

Amigoni

Sartori

et al. 2023

Preprint

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Study Objective: The aim of the project was to compare the efficacy and safety of intranasal and intravenous dexmedetomidine (DEX) in procedural sedation for electroencephalogram (EEG) in patients with behavioural disorders. Design: observational monocentric comparative study Setting: Tertiary care centre Emergency Department Patients: all consecutive patients < 18 years old affected by behavioural disorders, who needed sedation for EEG recording. From 2018 to 2020 a group of children received intravenous administration of DEX, the following year a second group of children received intranasal administration of the same drug. Target of sedation was level 2, according to the Paediatric Sedation State Scale (PSSS) in both groups. Heart rate (HR), pulse oxygen saturation and blood pressure (BP) were registered. EEG recording quality and caregivers’ satisfaction were collected. Results: Twenty-four patients were sedated with intravenous and other twenty-four with intranasal DEX. Sedation success rate was 97.9%. Intranasal administration showed longer onset (p <0.0001), but shorter offset (p 0.0145); 45.8% patients reported adverse effects. Bradycardia occurred in 35.4% of the overall population, cases of hypotension were still reported in the intravenous group. All adverse effects were self-resolved without any intervention. EEG recording quality and level of satisfaction among caregivers and EEG technicians were high. Conclusions: Considering our data dexmedetomidine is an effective and safe drug in patients with behavioural disorders. Intranasal administration could be useful as it is less invasive and with shorter offset. Clinical Trial registration: ID NCT 03799783; date registered: 10/01/2019

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Section: Discussionmentioning

confidence: 97%

Dexmedetomidine for Electroencephalogram in patients with behavioural disorders: a comparative study between intranasal and intravenous administration

Poletto

Amigoni

Sartori

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Dex is commonly used for sedation in intensive care units and for procedural sedation in children ( 19 ). It provides sedation without respiratory depression and major effects on the cardiovascular system, has minimal effects on EEG peak frequency and amplitude, does not affect seizures or alter spike-wave activity ( 20 – 22 ). However, Dex has not been extensively used for sleep induction prior to EEG in pediatric patients and it's safety for this purpose has not been clearly established.…”

Section: Introductionmentioning

confidence: 99%

Melatonin vs. dexmedetomidine for sleep induction in children before electroencephalography

Peganc Nunčič,

Neubauer,

Oražem Mrak

et al. 2024

Front. Pediatr.

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Background and objectivesIn children requiring electroencephalography (EEG), sleep recording can provide crucial information. As EEG recordings during spontaneous sleep are not always possible, pharmacological sleep-inducing agents are sometimes required. The aim of the study was to evaluate safety and efficacy of melatonin (Mel) and dexmedetomidine (Dex; intranasal and sublingual application) for sleep induction prior to EEG.MethodsIn this prospective randomized study, 156 consecutive patients aged 1–19 years were enrolled and randomized by draw into melatonin group (Mel; n = 54; dose: 0.1 mg/kg), dexmedetomidine (Dex) sublingual group (DexL; n = 51; dose: 3 mcg/kg) or dexmedetomidine intranasal group (DexN; n = 51; dose: 3 mcg/kg). We compared the groups in several parameters regarding efficacy and safety and also carried out a separate analysis for a subgroup of patients with complex behavioral problems.ResultsSleep was achieved in 93.6% of participants after the first application of the drug and in 99.4% after the application of another if needed. Mel was effective as the first drug in 83.3% and Dex in 99.0% (p < 0.001); in the subgroup of patients with complex developmental problems Mel was effective in 73.4% and Dex in 100% (p < 0.001). The patients fell asleep faster after intranasal application of Dex than after sublingual application (p = 0.006). None of the patients had respiratory depression, bradycardia, desaturation, or hypotension.ConclusionsMel and Dex are both safe for sleep induction prior to EEG recording in children. Dex is more effective compared to Mel in inducing sleep, also in the subgroup of children with complex behavioral problems. Clinical Trial RegistrationDexmedetomidine and Melatonin for Sleep Induction for EEG in Children, NCT04665453.

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Dexmedetomidine for electroencephalogram in children with behavioural disorders: a comparative study between intranasal and intravenous administration

Poletto,

Amigoni,

Sartori

et al. 2024

Intensive Care Med. Paediatr. Neonatal

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Objective The aim of the project was to compare the efficacy and safety of intranasal (IN) and intravenous (IV) dexmedetomidine (DEX) in procedural sedation for electroencephalogram (EEG) in paediatric patients with behavioural disorders. Methods Single-centre comparative observational study in the tertiary care centre of Padua, regarding all consecutive patients < 18 years old affected by behavioural disorders, who needed sedation for EEG recording. From 2018 to 2019 a group of children received IV administration of DEX, from 2020 to 2021 a second group of children received IN administration of the same drug. In both groups, the target of sedation was level 2, in accordance with the Paediatric Sedation State Scale (PSSS). Heart rate (HR), pulse oxygen saturation and blood pressure (BP) were registered. The quality of the EEG recordings and the satisfaction of caregivers were collected. Results DEX was used in 48 patients (IV = 24; IN = 24) with total sedation success rate of 98%. Only one patient failed with IN DEX. IN DEX showed longer median onset time (p < 0.01), but shorter offset (p = 0.01) than IV route. All adverse effects were self-resolved. The IN group reported 9 cases of bradycardia, while hypotension and hypertension occurred in the IV group. EEG recording quality and level of satisfaction among caregivers and EEG technicians were high in both groups. Conclusions IN DEX is an effective sedative; its recovery time shorter than IV DEX and its favourable adverse events profile make this route a reasonable alternative, especially in paediatric patients with a low compliance to procedures.

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Dexmedetomidine for EEG sedation in children with behavioral disorders

Cited by 5 publications

References 20 publications

Dexmedetomidine for Electroencephalogram in patients with behavioural disorders: a comparative study between intranasal and intravenous administration

Dexmedetomidine for Electroencephalogram in patients with behavioural disorders: a comparative study between intranasal and intravenous administration

Melatonin vs. dexmedetomidine for sleep induction in children before electroencephalography

Dexmedetomidine for electroencephalogram in children with behavioural disorders: a comparative study between intranasal and intravenous administration

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