• Acta Anaesthesiol Scand · Apr 2020

    Incidence and risk factors of bradycardia in pediatric patients undergoing intranasal dexmedetomidine sedation.

    • Huang Lei, Li Chao, Tan Miao, Li Ya Jun, Liu Shen Ling, Pu Yan Ying, Xiao HanPengPSedation and Analgesia Center, Kunming Children's Hospital, Kunming, China., Yun BoXuXSedation and Analgesia Center, Kunming Children's Hospital, Kunming, China., and Tan Xin.
    • Sedation and Analgesia Center, Kunming Children's Hospital, Kunming, China.
    • Acta Anaesthesiol Scand. 2020 Apr 1; 64 (4): 464-471.

    BackgroundDexmedetomidine is widely used for non-invasive pediatric procedural sedation. However, the hemodynamic effects of intravenous dexmedetomidine are a concern. There has been a growing interest in the application of intranasal dexmedetomidine as a sedative in children.ObjectiveTo investigate the incidence of bradycardia in children undergoing intranasal dexmedetomidine sedation and to identify the associated risk factors.MethodsData pertaining to pediatric patients who underwent intranasal dexmedetomidine sedation for non-invasive investigations at the Kunming Children's Hospital between October 2017 and August 2018 were retrospectively analyzed.ResultsOut of 9984 children who qualified for inclusion, 228 children (2.3%) developed bradycardia. The incidence of bradycardia in the group that received additional dose of dexmedetomidine was higher than that in the group that did not receive additional dose (9.2% vs 16.7%; P = .003). The incidence of bradycardia in males was higher than that in females (2.6% vs 1.8%; P = .007). On multivariate logistic regression, only male gender showed an independent association with the occurrence of bradycardia (odds ratio 1.48; 95% confidence interval 1.11-1.97; P = .008).ConclusionsThe overall incidence of bradycardia in children after sole use of intranasal dexmedetomidine sedation was 2.3%. Male children showed a 1.48-fold higher risk of bradycardia. However, the blood pressure of the children who developed bradycardia was within the normal range. Simple wake-up can effectively manage bradycardia induced by intranasal dexmedetomidine sedation.© 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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