Intranasal dexmedetomidine and intranasal ketamine association allows shorter induction time for pediatric sedation compared to intranasal dexmedetomidine and oral midazolam
Open Access
- 10 January 2022
- journal article
- letter
- Published by Springer Science and Business Media LLC in Italian Journal of Pediatrics
- Vol. 48 (1), 1-5
- https://doi.org/10.1186/s13052-021-01196-0
Abstract
Non-painful diagnostic procedures require an inactive state for a prolonged time, so that sedation is often needed in younger children to perform the procedures. Our standard of care in this setting consists of the association between oral midazolam (0.5 mg/kg) and intranasal dexmedetomidine (4 mcg/kg). One of the limits of this approach is that the onset of action is quite delayed (up to 55 min) and poorly predictable. We chose to compare this association with intranasal-ketamine and intranasal-dexmedetomidine. This is a “pre-post” study. The study population included the first forty children receiving sedation with the “new” combination intranasal ketamine (3 mg/kg) and intranasal dexmedetomidine (4 mcg/kg) compared to a historical cohort including the last forty children receiving sedation with our standard of care combination of intranasal dexmedetomidine (4mcg/kg) and oral midazolam (0,5 mg/kg). The association intranasal dexmedetomidine and intranasal ketamine allowed for a significantly shorter sedation induction time than the combination intranasal dexmedetomidine and oral midazolam (13,5 min versus 35 min). Both group’s cumulative data showed a correlation between age and sedation effectiveness, with younger children presenting a higher success rate and shorter induction time (p 0,001). Conclusions: This study suggests that the ketamine and dexmedetomidine intranasal association may have a shorter onset of action when compared to intranasal dexmedetomidine and oral midazolam.Keywords
This publication has 8 references indexed in Scilit:
- Sedation effects of intranasal dexmedetomidine combined with ketamine and risk factors for sedation failure in young children during transthoracic echocardiographyPediatric Anesthesia, 2018
- Intranasal dexmedetomidine, as midazolam‐sparing drug, for MRI in preterm neonatesPediatric Anesthesia, 2018
- Tracking and Reporting Outcomes Of Procedural Sedation (TROOPS): Standardized Quality Improvement and Research Tools from the International Committee for the Advancement of Procedural SedationBritish Journal of Anaesthesia, 2018
- Combination of intranasal dexmedetomidine and oral midazolam as sedation for pediatric MRIPediatric Anesthesia, 2017
- A comparison of intranasal ketamine and intranasal midazolam for pediatric premedicationAnesthesia: Essays and Researches, 2015
- Sedation for radiological imagingArchives of Disease in Childhood: Education & Practice, 2010
- The post-anesthesia recovery score revisitedJournal of Clinical Anesthesia, 1995
- Premedication of children with oral midazolamCanadian Journal of Anesthesia/Journal canadien d'anesthésie, 1992