Intramuscular Dexmedetomidine Sedation for Pediatric MRI and CT

Sedation in pediatrics continues to be an area of great interest among researchers, as clinicians try to balance adequate sedation, side-effect profiles, and less painful administration of pharmacologic agents. In this retrospective chart review, researchers examined the efficacy of intramuscular (IM) dexmedetomidine for sedation in children undergoing diagnostic imaging, as well as assessing the safety of the agent in the same population. Sixty-five children from age 1 month to 10 years, with the majority being 2–3 years of age, undergoing magnetic resonance imaging or computed tomography scans for non-traumatic indications received dexmedetomidine for sedation. Patients were not eligible for dexmedetomidine for a variety of pre-existing conditions, such as obesity, intracranial bleeding, or long QT syndrome. Adequate sedation was defined by completion of the indicated imaging study and a Ramsey sedation score of four or greater, and all patients achieved this goal. All but 4 patients required only one dose of dexmedetomidine, but dosing varied widely from 1 to 6 μg/kg. Average time to adequate sedation was 13 min, and average time to recovery was < 30 min. Nine patients (14%) experienced hypotension, although none required intervention, and hypotension was not related to the dose administered. None of the patients had bradycardia, hypertension, or oxygen desaturation.