Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Intranasal Dexmedetomidine as Sedative for Medical Imaging in Young Children: A Systematic Review to Provide a Roadmap for an Evidence-guided Clinical Protocol

Version 1 : Received: 16 August 2022 / Approved: 17 August 2022 / Online: 17 August 2022 (09:44:28 CEST)

A peer-reviewed article of this Preprint also exists.

Hermans, K.; Ramaekers, L.; Toelen, J.; Vanhonsebrouck, K.; Allegaert, K. Intranasal Dexmedetomidine as Sedative for Medical Imaging in Young Children: A Systematic Review to Provide a Roadmap for an Evidence-Guided Clinical Protocol. Children 2022, 9, 1310. Hermans, K.; Ramaekers, L.; Toelen, J.; Vanhonsebrouck, K.; Allegaert, K. Intranasal Dexmedetomidine as Sedative for Medical Imaging in Young Children: A Systematic Review to Provide a Roadmap for an Evidence-Guided Clinical Protocol. Children 2022, 9, 1310.

Journal reference: Children 2022, 9, 1310
DOI: 10.3390/children9091310

Abstract

There is an increasing need for effective anxiety and pain reduction during medical imaging procedures in children. This is a complex issue, addressed by both non-pharmacological or pharmacological approaches. Dexmedetomidine is a fairly recently marketed, selective α2-adrenergic agonist, and can be administered intranasally. To develop an evidence-guided clinical protocol, we investigated its (side)-effects, preconditions and safety aspects following intranasal dexmedetomidine in children (1 month-5 years) for procedural sedation during medical imaging. To do so, a systematic search (PubMed, Embase, CINAHL (12/2021)) was performed to identify clinical studies on intranasal dexmedetomidine for procedural sedation for medical imaging (Computer Tomography, Magnetic Resonance Imaging). Following screening and quality assessment, 8 studies were retained. Nasal nebulization was considered the best administration method, dosing varied between 2 to 4 µg/kg (age-dependent) 30-45 minutes prior to imaging, and contra-indications or restrictions on oral intake were somewhat consistent across studies. Valid sedation scores were routinely used to assess sedation and the need for rescue dosing, while discharge was generally based on the Aldrete score (score ≥9). Heart rate, blood pressure and saturation were routinely monitored, with commonly observed bradycardia or hypotension (decrease by 20%). Based on these findings, a roadmap for evidence-guided clinical protocol was generated.

Keywords

procedural sedation; children; dexmedetomidine; imaging

Subject

MEDICINE & PHARMACOLOGY, Nursing & Health Studies

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