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Drug therapy
Dexmedetomidine improves success of paediatric MRI sedation
  1. Thomas J Jackson1,2,
  2. Deborah Dawes1,
  3. Shaista Ahmad3,
  4. Darren Martin3,
  5. Cassandra Gyamtso1
  1. 1 Paediatrics, North Middlesex University Hospital, London, UK
  2. 2 UCL Great Ormond Street Institute of Child Health, London, UK
  3. 3 Pharmacy, North Middlesex University Hospital, London, UK
  1. Correspondence to Dr Thomas J Jackson, Paediatrics, North Middlesex University Hospital, London, UK; thomas.jackson4{at}nhs.net

Abstract

Objective To improve success rates of children requiring sedation for MRI.

Methods Audits of sedation success for children attending planned MRI using three different approaches: (1) National Institute for Health and Care Excellence (NICE) guidance (chloral hydrate if <15 kg and oral midazolam if ≥15 kg), (2) Chloral hydrate for all patients, (3) Chloral hydrate±intranasal dexmedetomidine if <15 kg and intranasal dexmedetomidine alone if ≥15 kg.

Results 74 patients had 85 MRI scan attempts. Overall success rates were significantly higher when using intranasal dexmedetomidine compared with following NICE guidance (81% vs 52% p=0.017). Dexmedetomidine performed better than oral midazolam for the same indication (76% vs 33% p=0.026). The side effect profile for dexmedetomidine was as reported in larger studies.

Conclusions Intranasal dexmedetomidine is an effective alternative to oral midazolam for sedation for MRI and as a rescue medication where chloral hydrate has been ineffective.

  • child health
  • paediatrics
  • magnetic resonance imaging

https://doi.org/10.1136/archdischild-2021-322734

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    Footnotes

    • Correction notice This article has been updated since it was first published. Table 1 has been corrected.

    • Contributors TJJ, DD, SA, DM and CG were involved at various stages of conception of the project. TJJ and DD collected data, TJJ analysed the data, TJJ drafted the manuscript and all other authors contributed revisions.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.