Intranasal dexmedetomidine for sedation in children; a review

• Published in: Journal of Perioperative Practice Vol. 30; no. 6; pp. 170 - 175
• Main Authors: Lewis, J, Bailey, CR
• Format: Book Review Journal Article
• Language: English
• Published: London, England SAGE Publications 01-06-2020; Association for Perioperative Practice
• Subjects: Anesthesia; Drug administration; Nursing; Pediatrics; Intranasal dexmedetomidine / Children / Sedation / Paediatrics
• ISSN: 1750-4589; 2515-7949
• DOI: 10.1177/1750458919854885

Dexmedetomidine is an α2 adrenoreceptor agonist that may be administered by the intranasal route as a sole sedative agent in children. It is odourless, colourless and tasteless and is formulated in a concentration of 100µg.ml−1. We performed a review of published randomised controlled trials in order to determine the efficacy of intranasal dexmedetomidine for sedation in children. Fourteen trials were eligible for inclusion in the review and contained a total of 1809 patients ranging in age from one month to 14 years. Intranasal dexmedetomidine was administered in a dose range of 1–4µg.kg−1 and was compared with various other sedatives. Dexmedetomidine was administered by either drops or a mucosal atomiser device. The procedures ranged from non-painful examinations such as magnetic resonance imaging scans and transthoracic echocardiography to painful procedures such as dentistry and venous cannulation. Administration of 2µg.kg−1 appears to be the optimal dose.