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PEDIATRIC ANESTHESIA

Dexmedetomidine for Pediatric Sedation for Computed Tomography Imaging Studies

Keira P. Mason, MD^*, Steven E. Zgleszewski, MD^*, Jennifer L. Dearden, MD^*, Raymond S. Dumont, MD^*, Michele A. Pirich, RN, BSN, Cynthia D. Stark, RN, CPNP, Peggy D'Angelo, BSN, RN, Shann MacPherson, BSN, RN, Paulette J. Fontaine, BS, Linda Connor, RN, and David Zurakowski, PhD^*

From the Departments of *Anesthesia, Radiology, and Biostatistics, Children's Hospital Boston and Harvard Medical School, 300 Longwood Avenue, Boston, Massachusetts 02115.

Address correspondence and reprint requests to Keira P. Mason, MD, Department of Anesthesia, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, Tel: 617-355-7737, Fax: 617-278-9237; Email: keira.mason{at}childrens.harvard.edu

Dexmedetomidine is a sedative with limited experience in the pediatric population. This is the first study that prospectively evaluates the sedation profile of a dexmedetomidine pilot program for pediatric sedation for radiological imaging studies. In March 2005, our hospital sedation committee approved the replacement of IV pentobarbital with dexmedetomidine as the standard of care for CT imaging. Detailed Quality Assurance (QA) data sheets collect relevant information on each patient, which is then logged into a computerized sedation database. After IRB approval, all QA data was accessed. Sixty-two patients with a mean age of 2.8 years (SD = 1.8, range 0.5–9.7) received IV (IV) dexmedetomidine administered as a 2 mcg/kg loading dose over 10 minutes, followed by repeat boluses of 2 mcg/kg over 10 minutes until target of Ramsay Sedation Score 4 (RSS) achieved. Patients were then maintained on 1 mcg/kg/hr infusion until imaging is completed. Repeated-measures ANOVA indicated that compared to pre-sedation values, the heart rate and mean arterial blood pressure decreased an average of 15% during bolus, infusion and recovery (P < 0.01). No significant changes were observed in respiratory rate or end-tidal CO₂. Mean recovery time was 32 ± 18 minutes. Based on our pilot results, dexmedetomidine may provide a reliable and effective method of providing sedation.

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