Dexmedetomidine for sedation during electroencephalographic analysis in children with autism, pervasive developmental disorders, and seizure disorders

Abstract

Study ObjectiveTo assess the efficacy of dexmedetomidine in providing sedation during electroencephalographic (EEG) analysis in children with autism, seizure disorders, or pervasive developmental disorders (PDDs). DesignRetrospective chart review. SettingUniversity medical center. MeasurementsThe charts of 42 children, aged two to 11 years, who received dexmedetomidine for sedation during EEG analysis, were studied. Information collected included route of administration of dexmedetomidine (oral and/or intravenous [IV]), loading dose, and infusion rate. Heart rate, blood pressure, respiratory rate, and level of sedation were monitored every 5 minutes, and oxygen saturation was monitored continuously during the procedure. Interventions (administration of fluid or use of an anticholinergic agent) for hypotension or bradycardia were identified. Main Results18 children received oral dexmedetomidine (range, 2.9-4.4 μg/kg) before placement of an IV. Forty patients received an IV loading dose of dexmedetomidine (2.1 ± 0.8 μg/kg), which was given in increments of 0.5 to one μg/kg every three to 5 minutes until a sedation score of 3 to 4 was achieved. Effective sedation was eventually achieved in all patients. An IV infusion of dexmedetomidine was started (1.5 ± 0.2 μg kg−1 hr−1) in all patients. During performance of the EEG, adjustments in the infusion rate (increase or decrease) or additional bolus doses were necessary in 25 patients. No significant hemodynamic or respiratory effects were noted. ConclusionsDexmedetomidine provides effective sedation during EEG analysis in children with autism or PDD.