Application of intranasal dexmedetomidine in magnetic resonance imaging of preterm infants: The ED50, efficacy and safety analysis

• Published in: Medicine (Baltimore) 2024-05, Vol.103 (18), p.e38040-e38040
• Main Authors: Wan, Shengjun, Wu, Wei, Bu, Wenhao
• Format: Article
• Language: English
• Subjects: Administration, Intranasal; Clinical Trial/Experimental Study; Dexmedetomidine - administration & dosage; Dexmedetomidine - adverse effects; Dose-Response Relationship, Drug; Female; Heart Rate - drug effects; Humans; Hypnotics and Sedatives - administration & dosage; Hypnotics and Sedatives - adverse effects; Infant, Newborn; Infant, Premature; Magnetic Resonance Imaging - methods; Male; Oxygen Saturation - drug effects; Prospective Studies
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000038040

Infants undergoing magnetic resonance imaging (MRI) often require pharmacological sedation. Dexmedetomidine serves as a novel sedative agent that induces a unique unconsciousness similar to natural sleep, and therefore has currently been used as the first choice for sedation in infants and young children. To determine the 50% effective dose (ED50) and 95% confidence interval (95%CI) of intranasal dexmedetomidine for MRI in preterm and term infants, and to observe the incidence of adverse events. To explore whether there were differences in ED50 and 95%CI, heart rate (HR) and blood oxygen saturation (SpO2), the induction time and wake-up time and the incidence of adverse events between the 2 groups, so as to provide guidance for clinical safe medication for the meanwhile. A total of 68 infants were prospectively recruited for MRI examination under drug sedation (1 week ≤ age ≤ 23 weeks or weight ≤ 5kg). The children were divided into 2 groups according to whether they had preterm birth experience (Preterm group, Atterm group). The Dixon up-and-down method was used to explore ED50. The basic vital signs of the 2 groups were recorded, and the heart rate and SpO2 were recorded every 5 minutes until the infants were discharged from the hospital. The induction time, wake-up time and adverse events were recorded. The ED50 (95%CI) of intranasal dexmedetomidine in the Preterm group and the Atterm group were 2.23 (2.03-2.66) μg/kg and 2.64 (2.49-2.83) μg/kg, respectively (P