Universität zu Köln

Leister, Nicolas ORCID: 0000-0003-1932-0701, Yucetepe, Sirin, Ulrichs, Christoph, Pietsch, Steffi, Schink, Ullrich, Kilian, Janine, Menzel, Christoph and Trieschmann, Uwe ORCID: 0000-0003-2529-9005 (2022). Dexmedetomidine as a sole sedative for procedural sedation in preterm and neonate infants: A retrospective analysis. Pediatr. Anesth., 32 (8). S. 907 - 916. HOBOKEN: WILEY. ISSN 1460-9592

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Abstract

Background Many different sedation concepts for magnetic resonance imaging have been described for prematurely and term-born infants, ranging from no sedation to general anesthesia. Dexmedetomidine is an alpha-2 receptor agonist that is frequently used to sedate older children, because the anesthesiologist can easily adjust sedation depth, the patient maintains spontaneous breathing, and awakens rapidly afterwards. Aims The present study evaluates whether dexmedetomidine could safely be used as the sole sedative for prematurely and term-born infants less than 60 weeks postconceptional age undergoing diagnostic procedures. Methods We performed a retrospective monocentric analysis of n = 39 prematurely and term-born infants (<60 weeks postconceptional age or a body weight <5 kg) who were sedated with dexmedetomidine for an MRI at a German university hospital from August 2016 to November 2018. Results Successful imaging was achieved in all cases. The median initial bolus of dexmedetomidine administered over 10 min was 1.39 mu g kg(-1) body weight (range 0.34-3.64 mu g kg(-1)), followed with a continuous infusion at a median rate of 1.00 mu g kg(-1) h(-1) (range 0.5-3.5 mu g kg(-1) h(-1)); however, 3 patients (7%) needed some additional sedation (ketamine or propofol). All patients, including 10 infants who had previously required respiratory support, underwent the procedure without any relevant desaturation or apnea. Bradycardia was observed in up to 15 out of 39 cases (38.5%), but only four (10.3% in total and 26.7% of bradycardia) required atropine. Conclusions These results indicate that dexmedetomidine can be safely used for procedural sedation in the high-risk cohort of prematurely and term-born infants less than 60 weeks postconceptional age. Apnea during procedural sedation and subsequent stay in the recovery room is avoided, but bradycardia remains a relevant risk that may require treatment.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Leister, Nicolas UNSPECIFIED orcid.org/0000-0003-1932-0701 UNSPECIFIED Yucetepe, Sirin UNSPECIFIED UNSPECIFIED UNSPECIFIED Ulrichs, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Pietsch, Steffi UNSPECIFIED UNSPECIFIED UNSPECIFIED Schink, Ullrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Kilian, Janine UNSPECIFIED UNSPECIFIED UNSPECIFIED Menzel, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Trieschmann, Uwe UNSPECIFIED orcid.org/0000-0003-2529-9005 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-664285
DOI:	10.1111/pan.14461
Journal or Publication Title:	Pediatr. Anesth.
Volume:	32
Number:	8
Page Range:	S. 907 - 916
Date:	2022
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1460-9592
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROPOFOL; NEUROTOXICITY; CHILDREN; SAFETY; BRAIN; ANESTHESIA Multiple languages Anesthesiology; Pediatrics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66428