Sulton Carmen, Kamat Pradip, Mallory Michael, Reynolds Jason
From the Division of Emergency Medicine, Department of Pediatrics.
Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine.
Pediatr Emerg Care. 2020 Mar;36(3):138-142. doi: 10.1097/PEC.0000000000001199.
The objective of this study was to describe the use of intranasal dexmedetomidine (IN DEX) for sedated magnetic resonance imaging (MRI) examinations in children. The use of IN DEX for MRI in children has not been well described in the literature.
The Pediatric Sedation Research Consortium (PSRC) is a collaborative and multidisciplinary group of sedation practitioners dedicated to understanding and improving the process of pediatric sedation. We searched the 2007 version of the PSRC database solely for instances in which IN DEX was used for MRI diagnostic studies. Patients receiving intravenous medications were excluded. Patient demographics, IN DEX dose, adjunct medications and dose, as well as procedure completion, complications, interventions, and monitoring providers were analyzed.
A total of 224 sedation encounters were included in our primary analysis. There were no major adverse events. Most sedations (88%) required no intervention. Registered nurses were the monitoring provider in over 99% of cases. The median (interquartile range) dose of dexmedetomidine was 3 (2.5-3) mcg/kg. Adjunctive midazolam was used in 219/224 (98%) of the cases. All procedures were completed.
This report from the PSRC shows that IN DEX in combination with midazolam is an effective medication regimen for children who require an MRI with sedation.
本研究的目的是描述鼻内给予右美托咪定(IN DEX)用于儿童镇静磁共振成像(MRI)检查的情况。关于IN DEX在儿童MRI检查中的应用,文献中尚无充分描述。
儿科镇静研究联盟(PSRC)是一个由镇静从业者组成的跨学科合作团队,致力于理解和改进儿科镇静过程。我们仅在2007版PSRC数据库中搜索IN DEX用于MRI诊断研究的案例。排除接受静脉用药的患者。分析患者人口统计学资料、IN DEX剂量、辅助用药及剂量,以及检查完成情况、并发症、干预措施和监测人员。
我们的初步分析共纳入224例镇静案例。未发生重大不良事件。大多数镇静(88%)无需干预。超过99%的案例中,注册护士为监测人员右美托咪定的中位(四分位间距)剂量为3(2.5 - 3)μg/kg。219/224(98%)的案例使用了辅助性咪达唑仑所有检查均完成。
PSRC的这份报告表明IN DEX联合咪达唑仑是需要镇静进行MRI检查的儿童的一种有效药物方案。