Dexmedetomidine sedation in children
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Oulu University Hospital, Auditorium 12, Kajaanintie 50, 90220 Oulu
Topic of the dissertation
Dexmedetomidine sedation in children
Doctoral candidate
Licentiate of Medicine Miikka Tervonen
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, PEDEGO Research Unit and Medical Research Center Oulu
Subject of study
Medicine
Opponent
Docent Tuula Manner, Turku University Hospital
Custos
Professor Terhi Ruuska, Oulu University Hospital
Pediatric procedural sedation practices in Finland and dexmedetomidine sedation in children
The aim of the study was to survey the procedural sedation practices in Finland outside intensive care units and operation rooms. The safety and efficacy of intranasal dexmedetomidine, an analgosedative drug, was compared to midazolam and chloral hydrate during pediatric procedures. Adverse effects of dexmedetomidine were studied in a retrospective cohort study including intensive care patients aged under six months.
65% of the 71 pediatric specialist doctors that responded to the survey reported to provide sedation for children at least on a weekly basis. The monitoring of the patients and the availability of equipment for managing adverse events could be improved. Only one third of the respondents had received specific training in sedating pediatric patients and managing adverse events.
Intranasal dexmedetomidine was found more effective in providing sufficient sedation than midazolam during pediatric procedures. When compared to chloral hydrate there was no different in the success of the procedures but chloral hydrate caused nausea and vomiting more often. Adverse effects of dexmedetomidine were rare and mild. According to the patient series low blood pressure and heart rate were common among under six-month-old intensive care patients receiving dexmedetomidine.
Patient safety could be enhanced by systematically monitoring children receiving sedation and improving the availability of the equipment and medication needed to treat the adverse events. Intranasal dexmedetomidine sedation should be preferred over midazolam and chloral hydrate. When administering intravenous dexmedetomidine to patients under the age of six months lower doses might be advisable in avoiding the adverse effects.
65% of the 71 pediatric specialist doctors that responded to the survey reported to provide sedation for children at least on a weekly basis. The monitoring of the patients and the availability of equipment for managing adverse events could be improved. Only one third of the respondents had received specific training in sedating pediatric patients and managing adverse events.
Intranasal dexmedetomidine was found more effective in providing sufficient sedation than midazolam during pediatric procedures. When compared to chloral hydrate there was no different in the success of the procedures but chloral hydrate caused nausea and vomiting more often. Adverse effects of dexmedetomidine were rare and mild. According to the patient series low blood pressure and heart rate were common among under six-month-old intensive care patients receiving dexmedetomidine.
Patient safety could be enhanced by systematically monitoring children receiving sedation and improving the availability of the equipment and medication needed to treat the adverse events. Intranasal dexmedetomidine sedation should be preferred over midazolam and chloral hydrate. When administering intravenous dexmedetomidine to patients under the age of six months lower doses might be advisable in avoiding the adverse effects.
Last updated: 15.3.2024