Efficacy of intranasal dexmedetomidine sedation for radiological scanning in infants 1 year with congenital heart disease

Abstract

Objective The purpose of this study was to evaluate the efficacy and safety of intranasal dexmedetomidine(Dex) compared with traditional medications for rescue sedation during radiological scanning in infants under 12 months with congenital heart disease(CHD). Methods Based on an intention of treating protocol, this prospective single-blinded randomized clinical trial includes total 347 infants diagnosed with CHD who were not adequately sedated after initial oral dose of 50 mg/kg chloral hydrate. They were randomly divided into three groups. Group A received intramuscular phenobarbital of 5 mg/kg. Group B received second oral dose chloral hydrate 25 mg/kg. Group C received intranasal Dex 1 μg/kg. Sedation onset and duration, parents satisfaction were recorded. The readings of heart rate, and oxygen saturation were recorded at baseline(T0), at 5 min(T1), 10 min(T2), 20 min(T3), sedation(T4), check end(T5) and time of wake-up(T6). Results The success rate of rescue sedation among three groups was 75.8%, 83.3% and 90.7% respectively. There was significantly difference in success rate between group C and group A(P 0.05). There were no significant differences in hemodynamic changes among three groups(P>0.05). Conclusions A dosage of intranasal Dex 1 μg/kg was found to be effective in infants under 12 months with congenital heart disease during radiologicalscanning as a rescue sedative with quicker sedation onset time, longer sedated time. Intranasal Dex is also more effective in infants with right to left shunt lesions than effect of phenobarbital. It did not increase the incidence of side effects and hemodynamic changes. Key words: Infants; Congenital heart disease; Radiological scanning; Sedation; Dexmedetomidine