Clinical Analysis of Intranasal Dexmedetomidine Combined With Midazolam in Pediatric Cranial Magnetic Resonance Examinations

• Published in: Journal of perianesthesia nursing Vol. 38; no. 6; pp. 925 - 929
• Main Authors: Li, Si-Jie, Shen, Kai-Feng, He, Li, Zhang, Yu-Ping, Ming, Li, Wu, Zhi-Feng
• Format: Journal Article
• Language: English
• Published: United States 01.12.2023
• Subjects: Child; Dexmedetomidine - adverse effects; Humans; Hypnotics and Sedatives; Magnetic Resonance Imaging - methods; Magnetic Resonance Spectroscopy; Midazolam; Prospective Studies; dexmedetomidine; cranial magnetic resonance examination; children; midazolam; sedation
• ISSN: 1089-9472; 1532-8473
• DOI: 10.1016/j.jopan.2023.02.005

To observe the efficacy and safety of intranasal dexmedetomidine combined with midazolam in cranial magnetic resonance imaging of children. A prospective, observational, single-arm, one-center study. A total of 474 children were scheduled for cranial 3.0 T MRI at the first time. All patients were initially given 3 mcg/kg dexmedetomidine combined with 0.15 mg/kg midazolam. The one-time success rate, vital signs before and after treatment, onset time, recovery time, and incidence of adverse reactions were recorded. The one-time success rate was 78.1%. There were significant differences in respiration, heart rate, and blood oxygen saturation before and after treatment (P < .001). The onset time was 10 (8-15) minutes. The average recovery time was 2.58 ± 1.10 hours. Only 1.27% (6 cases) of adverse reactions were observed, including bradycardia (3 cases, 0.6%), tachycardia (1 case, 0.2%), and startle (2 cases, 0.4%). No special treatment was needed. The success of the examination was significantly correlated with age (OR 1.320, 95% CI 1.019-1.710, P = .035) and onset time (OR 0.959, 95% CI 0.921-0.998, P = .038). Dexmedetomidine 3 mcg/kg combined with midazolam 0.15 mg/kg intranasally has a good sedative effect in pediatric cranial magnetic resonance examinations, little impact on breathing and circulation, and few adverse reactions. Age and onset time are related factors affecting the one-time success rate.