Intranasal dexmedetomidine following failed chloral hydrate sedation in children

Anaesthesia. 2014 Mar;69(3):240-4. doi: 10.1111/anae.12533. Epub 2014 Jan 21.

Abstract

Chloral hydrate is the most commonly used sedative for paediatric diagnostic procedures in China with a success rate of around 80%. Intranasal dexmedetomidine is used for rescue sedation in our centre. This prospective investigation evaluated 213 children aged one month to 10 years who were not adequately sedated following administration of chloral hydrate. Children were randomly assigned to receive rescue intranasal dexmedetomidine at 1 μg.kg(-1) (group 1), 1.5 μg.kg(-1) (group 2) or 2 μg.kg(-1) (group 3). The sedation level was assessed every 10 min using a modified observer's assessment of alertness/sedation scale. Successful rescue sedation in groups 1, 2 and 3 were 56 (83.6%), 66 (89.2%) and 51 (96.2%), respectively. Increasing the rescue dose was associated with an increased success rate with an odds ratio of 4.12 (95% CI 1.13-14.98), p = 0.032. We conclude that intranasal dexmedetomidine is effective for sedation in children who do not respond to chloral hydrate.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Intranasal
  • Child, Preschool
  • Chloral Hydrate / adverse effects*
  • Chloral Hydrate / antagonists & inhibitors*
  • Conscious Sedation*
  • Dexamethasone / administration & dosage
  • Dexamethasone / pharmacology*
  • Female
  • Humans
  • Hypnotics and Sedatives / adverse effects*
  • Hypnotics and Sedatives / antagonists & inhibitors*
  • Infant
  • Male
  • Odds Ratio
  • Prospective Studies
  • Treatment Failure

Substances

  • Hypnotics and Sedatives
  • Chloral Hydrate
  • Dexamethasone