Fifty Percent Effective Dose of Intranasal Dexmedetomidine Sedation for Transthoracic Echocardiography in Children With Cyanotic and Acyanotic Congenital Heart Disease

Yang F, Li S, Shi Y, Liu L, Ye M, Zhang J, Liu H, Liu F, Yu Q, Sun M, Tian Q, Tu S.

J Cardiothorac Vasc Anesth. 2020 Apr;34(4):966-971. doi: 10.1053/j.jvca.2019.11.037. Epub 2019 Dec 6.

PMID: 31899144

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Abstract

Objectives: To determine the 50% and 95% effective dose of intranasal dexmedetomidine sedation for transthoracic echocardiography in children with cyanotic and acyanotic congenital heart disease.

Design: A prospective, nonrandomized study.

Setting: A tertiary care teaching hospital.

Participants: Patients younger than 18 months with known or suspected congenital heart disease scheduled for transthoracic echocardiography with sedation.

Interventions: Patients were divided into a cyanotic group (blood oxygen saturation <85%) or an acyanotic group (blood oxygen saturation ≥85%). This study used Dixon’s up-and-down method sequential allocation design. In both groups, the initial dose of intranasal dexmedetomidine was 2 μg/kg and the gradient of increase or decrease was 0.25 μg/kg.

Measurements and main results: The 50% effective dose (95% confidence interval) of intranasal dexmedetomidine sedation for transthoracic echocardiography was 3.2 (2.78-3.55) μg/kg and 1.9 (1.69-2.06) μg/kg in the cyanotic and acyanotic groups, respectively. None of the patients experienced significant adverse events.

Conclusion: The 50% (95% confidence intervals) effective doses of intranasal dexmedetomidine sedation for transthoracic echocardiography were 3.2 (2.78-3.55) μg/kg and 1.9 (1.69-2.06) μg/kg in children with cyanotic and acyanotic congenital heart disease, respectively.

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