High-dose dexmedetomidine: bradycardia in paediatrics
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High-dose dexmedetomidine: bradycardia in paediatrics Sedation with high-dose IV dexmedetomidine "occasionally results in marked bradycardia" in paediatric patients, according to a study presented at the Annual Meeting of the American Society of Anesthesiologists. The researchers reviewed data on, and examined, 1921 patients aged 0.4 to 21 years (mean age 5.9 years) who had received high-dose IV dexmedetomidine (per protocol*) for sedation for MRI in during the period 1 Jan 2007 to 31 Dec 2007. A total of 68 patients (3.5%; 95% CI 2.8–4.5%) developed bradycardia**. There was no association between bradycardia and age or time of drug administration (bolus, infusion or recovery period), with bradycardia occurring at all time-points. For the majority of patients, mean arterial BP values remained normal during bradycardia. Two patients had BPs below 20% of the lowest normal age-adjusted values, and responded to IV fluids; one patient had a BP 20% above the highest normal age-adjusted value. All BP and HR values normalised prior to discharge from recovery. * IV dexmedetomidine 3 µg/kg bolus over 10 minutes to achieve minimum Ramsay Sedation Score (RSS) 4. If RSS 4 is not achieved with first bolus, the bolus is repeated (same dosage and time interval). After RSS 4 is attained, dexmedetomidine 2 µg/kg/h infusion is started immediately and continued to MRI completion. ** HR 20% below lowest age-adjusted normal awake value Mason KP, et al. Incidence of bradycardia in children receiving high-dose dexmedetomidine sedation for MRI studies. 2008 Annual Meeting of the American Society of Anesthesiologists (Abstr. on disk): abstr. 1000, 18 Oct 801127052 2008.
0114-9954/10/1227-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 8 Nov 2008 No. 1227
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