Comparison of ED of intranasal dexmedetomidine sedation in children with acyanotic congenital heart disease before and after cardiac surgery.
10.12122/j.issn.1673-4254.2020.06.14
- Author:
Jing ZHANG
1
;
Qing YU
2
;
Yang LIU
3
;
Hui LIU
4
;
Mang SUN
2
;
Qin TIAN
1
;
Shengfen TU
1
Author Information
1. Department of Anesthesiology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
2. China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing 400014, China.
3. Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
4. Ministry of Education Key Laboratory of Child Development and Critical Disorders, Chongqing 400014, China.
- Publication Type:Journal Article
- Keywords:
acyanotic congenital heart disease;
dexmedetomidine;
median effective dose;
pediatrics;
sedation
- MeSH:
Administration, Intranasal;
Cardiac Surgical Procedures;
Child;
Dexmedetomidine;
Heart Defects, Congenital;
surgery;
Humans;
Hypnotics and Sedatives
- From:
Journal of Southern Medical University
2020;40(6):864-868
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To compare the median effective dose (ED) of intranasal dexmedetomidine for procedural sedation in uncooperative pediatric patients with acyanotic congenital heart disease before and after cardiac surgery.
METHODS:We prospectively recruited 47 children (22 in preoperative group and 25 in postoperative group) who needed sedation for transthoracic echocardiography (TTE). A modified up-and-down sequential study design was employed to determine dexmedetomidine dose for each patient with a starting dose of 2 μg/kg in both groups; dexmedetomidine doses for subsequent subjects were determined according to the responses from the previous subject using the up-and-down method at a 0.25 μg/kg interval. The ED was determined using probit regression. The onset time, examination time, wake-up time and adverse effects were measured, and the safety was evaluated in terms of changes in vital signs every 5 min.
RESULTS:The ED value of intranasal dexmedetomidine for sedation was 1.84 μg/kg (95% : 1.68-2.00 μg/kg) in children with congenital heart disease before cardiac surgery, and 3.38 μg/kg (95% : 3.21-3.54 μg/kg) after the surgery. No significant difference was found between the two groups in the demographic variables, onset time, examination time, wake-up time, or adverse effects.
CONCLUSIONS:In children with acyanotic congenital heart disease, the ED of intranasal dexmedetomidine for TTE sedation increases to 3.38 μg/ kg after cardiac surgery from the preoperative value of 1.84 μg/kg.
