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intranasal dexmedetomidine

Babita Ghai, Kajal Jain, Akshay Kumar Saxena, Nidhi Bhatia, Kushaljit Singh Sodhi
BACKGROUND: Children undergoing computerized tomography (CT) frequently require sedation to allay their anxiety, and prevent motion artifacts and stress of intravenous (IV) cannulation. AIMS: The aim of this trial was to compare the effectiveness of oral midazolam and intranasal dexmedetomidine as sole premedicants in children for carrying out both IV cannulation as well as CT scanning, without the need for additional IV sedatives. METHODS: Fifty-nine children, aged 1-6 years, scheduled to undergo CT imaging under sedation were randomized to receive either 0...
October 13, 2016: Paediatric Anaesthesia
Laura S Bonanno, Stephanie Pierce, Jennifer Badeaux, James J FitzSimons
This review aims to identify the effectiveness of preoperative intranasal dexmedetomidine compared with oral midazolam for the prevention of emergence delirium in pediatric patients undergoing general anesthesia.
August 2016: JBI Database of Systematic Reviews and Implementation Reports
Wenhua Zhang, Yanting Fan, Tianyun Zhao, Jinghui Chen, Gaolong Zhang, Xingrong Song
BACKGROUND: The median effective dose (ED50) of intranasal dexmedetomidine after failed chloral hydrate sedation has not been described for children. This study aims to determine the ED50 of intranasal dexmedetomidine for rescue sedation in children aged 1 to 36 months, who were inadequately sedated by chloral hydrate administration during magnetic resonance imaging (MRI). METHODS: This study was performed on 120 children, who were 1 to 36 months old and underwent MRI scanning...
September 14, 2016: Anesthesiology
Maha A AlSarheed
OBJECTIVES: To identify the intranasal (IN) sedatives used to achieve conscious sedation during dental procedures amongst children. METHODS: A literature review was conducted by identifying relevant studies through searches on Medline. Search included IN of midazolam, ketamine, sufentanil, dexmedetomidine, clonidine, haloperidol, and loranzepam. Studies included were conducted amongst individuals below 18 years, published in English, and were not restricted by year...
September 2016: Saudi Medical Journal
Yiquan Lin, Ying Chen, Jingxia Huang, Hongbin Chen, Weihua Shen, Wenjun Guo, Qianru Chen, Hongfeng Ling, Xiaoliang Gan
STUDY OBJECTIVES: This study aimed to test the hypothesis that premedication with a single dose of intranasal dexmedetomidine (DEX) could not only reduce preoperative anxiety but also minimize the emergence agitation in children undergoing cataract surgery with sevoflurane anesthesia. DESIGN: Single-blinded, randomized, placebo-controlled clinical comparison study. SETTING: Academic medical center. PATIENTS: Ninety American Society of Anesthesiologists physical status 1 and 2 children scheduled for cataract surgery...
September 2016: Journal of Clinical Anesthesia
J-R Corcuera-Flores, J Silvestre-Rangil, A Cutando-Soriano, J López-Jiménez
OBJECTIVE: The main objective of this systematic literature review is to identify the safest and most effective sedative drugs so as to ensure successful sedation with as few complications as possible. STUDY DESIGN: A systematic literature review of the PubMed MEDLINE database was carried out using the key words "conscious sedation," "drugs," and "dentistry." A total of 1,827 scientific articles were found, and these were narrowed down to 473 articles after applying inclusion and exclusion criteria...
2016: Medicina Oral, Patología Oral y Cirugía Bucal
Parul Uppal Malhotra, Seema Thakur, Parul Singhal, Deepak Chauhan, Cheranjeevi Jayam, Ritu Sood, Yagyeshwar Malhotra
BACKGROUND: Pharmacological methods have been used as an adjunct to enhance child cooperativeness and facilitate dental treatment. OBJECTIVE: Purpose of this study was to evaluate and compare the effect of sedation by intranasal dexmedetomidine and oral combination drug midazolam-ketamine in a group of children with uncooperative behavior requiring dental treatment. MATERIALS AND METHODS: This was a prospective, randomized, double-blind study that included patients 3-9 years old with American Society of Anesthesiologists-I status...
April 2016: Contemporary Clinical Dentistry
Gurkaran Kaur Sidhu, Seema Jindal, Gurpreet Kaur, Gurpreet Singh, Kewal Krishan Gupta, Shobha Aggarwal
OBJECTIVES: To compare effectiveness of intranasal dexmedetomidine and clonidine as anxiolytics and sedatives in pediatric patients undergoing various surgeries. METHODS: This double blind randomized placebo controlled study was conducted on 105 surgical patients of American Society of Anesthesiologist (ASA) physical status І-ІІ, aged between 2 and 9 y in a tertiary-care hospital (February 2014 to September 2015). Participants were randomly allocated to three groups to receive either intranasal dexmedetomidine 2 μg/kg (Group І) or intranasal clonidine 3 μg/kg (Group ІІ) or intranasal saline 0...
June 4, 2016: Indian Journal of Pediatrics
Xiaoliang Gan, Haotian Lin, Jingjing Chen, Zhuoling Lin, Yiquan Lin, Weirong Chen
PURPOSE: It is a challenge to rescue ophthalmology examinations performed in children in the sedation room after initial chloral hydrate failure. Intranasal dexmedetomidine can be used in rescue sedation in children undergoing computed tomography. The present study aimed to assess the efficacy and tolerability of intranasal dexmedetomidine use in children undergoing ophthalmic examination after chloral hydrate failure. METHODS: Sixty uncooperative pediatric patients with cataract (aged 5-36 months; weight, 7-15 kg) presented for follow-up ophthalmic examination...
June 2016: Clinical Therapeutics
Ravi Bhat, M C B Santhosh, Venkatesh M Annigeri, Raghavendra P Rao
BACKGROUND: Goal of premedication in pediatric anesthesia are relieving pre and postoperative anxiety, good parental separation, and smooth induction of anesthesia. Anxiety can produce aggressive reactions, increased distress, increased postoperative pain and postoperative agitation. The benzodiazepine, midazolam, is the most frequently used premedication in pediatric anesthesia. Midazolam has a number of beneficial effects when used as premedication in children: Sedation, fast onset, and limited duration of action...
May 2016: Anesthesia, Essays and Researches
Chengxiang Lu, Li-Ming Zhang, Yuehong Zhang, Yanlu Ying, Ling Li, Lixin Xu, Xiangcai Ruan
BACKGROUND: Intranasal dexmedetomidine, a well-tolerated and convenient treatment option, has been shown to induce a favorable perioperative anxiolysis in children. We investigate intranasal dexmedetomidine as a sedative premedication for anesthesia recovery in an adult population. METHODS: A prospective randomized controlled trial; 81 adult patients scheduled for elective suspension laryngoscopy received intranasal dexmedetomidine (1 μg∙kg-1) or a placebo 45-60 min before anesthetic induction...
2016: PloS One
Xiang Wu, Li Hua Hang, Hong Wang, Dong Hua Shao, Yi Guo Xu, Wei Cui, Zheng Chen
PURPOSE: Intranasal dexmedetomidine is an effective sedative for premedication and is regularly used to reduce preoperative tension and anxiety in children. This study aimed to assess the effect of intranasally adjunctive dexmedetomidine on perioperative sedative and analgesic requirements in adults. MATERIALS AND METHODS: Patients were randomly divided into four groups to receive preoperative administration of saline, intranasal dexmedetomidine 1 μg/kg and 2 μg/kg, and intravenous dexmedetomidine 1 μg/kg, respectively...
July 2016: Yonsei Medical Journal
Desiree N W Neville, Katharina R Hayes, Yaron Ivan, Erin R McDowell, Raymond D Pitetti
OBJECTIVE: The objective of this study was to compare anxiolysis with intranasal dexmedetomidine, an alpha-2 agonist, versus intranasal midazolam for pediatric laceration repairs. METHODS: We performed a double-blind, randomized controlled trial of 40 patients 1-5 years with lacerations requiring suture repair in an academic pediatric emergency department (ED). Patients were randomized to receive either intranasal dexmedetomidine or intranasal midazolam. Our primary outcome measure was the anxiety score at the time of patient positioning for the laceration repair...
August 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
B L Li, N Zhang, J X Huang, Q Q Qiu, H Tian, J Ni, X R Song, V M Yuen, M G Irwin
Intranasal dexmedetomidine has been used successfully for sedation in children. A mucosal atomisation device delivers an atomised solution to the nasal mucosa which facilitates rapid and effective delivery of medication to the systemic circulation. We compared intranasal delivery of dexmedetomidine in a dose of 3 μ by either atomiser or drops from a syringe in children < 3 years old undergoing transthoracic echocardiography. Two hundred and seventy-nine children were randomly assigned to one or other group...
May 2016: Anaesthesia
Mark G Roback, Douglas W Carlson, Franz E Babl, Robert M Kennedy
PURPOSE OF REVIEW: The review provides an update on pharmacological techniques for procedural sedation for children outside the operating room. RECENT FINDINGS: An increasing number of studies of propofol, ketamine, nitrous oxide, dexmedetomidine, and intranasal administration of drugs for procedural sedation of children continue to be reported. SUMMARY: Propofol and ketamine are commonly used for procedural sedation in children and the use of dexmedetomidine and nitrous oxide is increasing...
March 2016: Current Opinion in Anaesthesiology
Jason Reynolds, Amber Rogers, Samantha Capehart, Peter Manyang, Mehernoor F Watcha
OBJECTIVE: Satisfactory conditions for auditory brainstem responses (ABR) screening tests for pediatric hearing loss are usually achieved with oral chloral hydrate (CH) sedation. When the US manufacture of this drug was discontinued for business reasons, we developed an alternative sedation regimen using intranasal dexmedetomidine (IN DEX) 4 μg/kg. This institutional review board-approved retrospective study compared the efficacy and adverse effect profiles of these 2 sedative regimens...
March 2016: Hospital Pediatrics
Jeffrey W Miller, Allison A Divanovic, Md M Hossain, Mohamed A Mahmoud, Andreas W Loepke
PURPOSE: We designed this retrospective observational study on the use of α2-agonist dexmedetomidine to determine the optimum intranasal dose to achieve sedation for pediatric transthoracic echocardiography and to identify any dose-related adverse effects. METHODS: Outpatient children aged three months to three years with diverse diagnoses of congenital heart disease, including cyanotic cardiac defects, underwent transthoracic echocardiography under dexmedetomidine sedation...
July 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Dae-Seung Ryu, Deok-Won Lee, Sung Chul Choi, In-Hwan Oh
PURPOSE: The aim of this study was to establish a proper sedative protocol of dexmedetomidine for outpatients. MATERIALS AND METHODS: The study compared compare patients' pain, satisfaction, adverse events, and sedation depth during extraction of third molars using a sedative protocol of intravenous (IV; 1.0 μg/kg) versus intranasal (IN; 1.5 μg/kg) administration of dexmedetomidine. In total, 240 patients were randomized, 160 patients received dexmedetomidine, and data, including the amount of agent used, visual analog scale (VAS) pain score, adverse events, VAS score of patient satisfaction, and bispectral index, were recorded...
May 2016: Journal of Oral and Maxillofacial Surgery
Jason Reynolds, Amber Rogers, Eduardo Medellin, Jonathan A Guzman, Mehernoor F Watcha
BACKGROUND: Dexmedetomidine is increasingly used by various routes for pediatric sedation. However, there are few randomized controlled trials comparing the efficacy of dexmedetomidine to other commonly used sedatives. AIM: To compare the efficacy of sedation with intranasal dexmedetomidine to oral chloral hydrate for auditory brainstem response (ABR) testing. METHODS: In this double-blind, double-dummy study, children undergoing ABR testing were randomized to receive intranasal dexmedetomidine 3 mcg · kg(-1) plus oral placebo (Group IN DEX) or oral chloral hydrate 50 mg · kg(-1) plus intranasal saline placebo (Group CH)...
March 2016: Paediatric Anaesthesia
Nicole M Baier, Suzanne S Mendez, Danielle Kimm, Amanda E Velazquez, Alan R Schroeder
OBJECTIVE: Dexmedetomidine is an α2 agonist with sedative, anxiolytic, and analgesic properties. The intranasal (IN) route avoids the pain of intravenous (i.v.) catheter placement but limited literature exists on the use of IN dexmedetomidine. This study examines the effectiveness and safety of IN dexmedetomidine for sedation of patients undergoing electroencephalogram (EEG) and auditory brain response (ABR) testing. STUDY DESIGN: This was a review of all outpatients sedated with IN dexmedetomidine for EEG or ABR between October 1, 2012 and October 1, 2014...
March 2016: Paediatric Anaesthesia
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