Sedative, haemodynamic and respiratory effects of dexmedetomidine in children undergoing magnetic resonance imaging examination: preliminary results

• Published in: British journal of anaesthesia : BJA Vol. 94; no. 6; pp. 821 - 824
• Main Authors: Koroglu, A, Demirbilek, S, Teksan, H, Sagır, O, But, A.K., Ersoy, M.O.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.06.2005; Oxford University Press; Oxford Publishing Limited (England)
• Subjects: Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Pressure - drug effects; brain; brain, magnetic resonance imaging; Child; Child, Preschool; Conscious Sedation - methods; dexmedetomidine; Dexmedetomidine - pharmacology; Drug Administration Schedule; Female; Heart Rate - drug effects; Hemodynamics - drug effects; Humans; Hypnotics and Sedatives - pharmacology; Infant; Magnetic Resonance Imaging; Male; Medical sciences; Midazolam - pharmacology; paediatrics; Prospective Studies; Respiration - drug effects; sedation; sedation, paediatrics; sedative; sedative, dexmedetomidine; brain, magnetic resonance imaging; sedation, paediatrics; sedative, dexmedetomidine; Rescue; Agonist; paediatrics; sedative; Intravenous administration; Sedation; Encephalon; magnetic resonance imaging; sedation; Benzodiazepine derivatives; Anesthesia; Arterial pressure; Propofol; Sedative; Child; Human; α2-Adrenergic receptor; Oxygen; Saturation; Single dose; Hypnotic; brain; Heart rate; General anesthetic; Dexmedetomidine; α-Adrenergic receptor agonist; Midazolam
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/aei119

We evaluated the sedative, haemodynamic and respiratory effects of dexmedetomidine and compared them with those of midazolam in children undergoing magnetic resonance imaging (MRI) procedures. Eighty children aged between 1 and 7 yr were randomly allocated to receive sedation with either dexmedetomidine (group D, n=40) or midazolam (group M, n=40). The loading dose of the study drugs was administered for 10 min (dexmedetomidine 1 μg kg−1 or midazolam 0.2 mg kg−1) followed by continuous infusion (dexmedetomidine 0.5 μg kg−1 h−1 or midazolam 6 μg kg−1 min−1). Inadequate sedation was defined as difficulty in completing the procedure because of the child's movement during MRI. The children who were inadequately sedated were given a single dose of rescue midazolam and/or propofol intravenously. Mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation ( SpO2) and ventilatory frequency (VF) were monitored and recorded during the study. The quality of MRI was significantly better and the rate of adequate sedation was higher in group D than in group M (P<0.001). In group D, the requirement for rescue drugs was lower and the onset of sedation time was shorter than in group M (P<0.001). MAP, HR and VF decreased from baseline during sedation in both groups (P<0.001). Dexmedetomidine provided adequate sedation in most of the children aged 1–7 yr without haemodynamic or respiratory effects during MRI procedures.