Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2016
Randomized Controlled Trial Comparative StudyComparison of rescue techniques for failed chloral hydrate sedation for magnetic resonance imaging scans-additional chloral hydrate vs intranasal dexmedetomidine.
Chloral hydrate, a commonly used sedative in children during noninvasive diagnostic procedures, is associated with side effects like prolonged sedation, paradoxical excitement, delirium, and unpleasant taste. Dexmedetomidine, a highly selective α-2 agonist, has better pharmacokinetic properties than chloral hydrate. We conducted this prospective, double-blind, randomized controlled trial to evaluate efficacy of intranasal dexmedetomidine with that of a second oral dose of chloral hydrate for rescue sedation during magnetic resonance imaging (MRI) studies in infants. ⋯ Intranasal dexmedetomidine induced satisfactory rescue sedation in 1- to 6-month-old infants during MRI study, and appears to cause sedation in a dose-dependent manner.
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Paediatric anaesthesia · Mar 2016
Intranasal dexmedetomidine: an effective sedative agent for electroencephalogram and auditory brain response testing.
Dexmedetomidine is an α2 agonist with sedative, anxiolytic, and analgesic properties. The intranasal (IN) route avoids the pain of intravenous (i.v.) catheter placement but limited literature exists on the use of IN dexmedetomidine. This study examines the effectiveness and safety of IN dexmedetomidine for sedation of patients undergoing electroencephalogram (EEG) and auditory brain response (ABR) testing. ⋯ IN dexmedetomidine is an effective and noninvasive method of sedating children for EEG and ABR.
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Paediatric anaesthesia · Mar 2016
Review Meta AnalysisAlpha-2 adrenoceptor agonists as adjuncts to peripheral nerve blocks in children: a meta-analysis.
Adult meta-analyses have verified that adjunct use of alpha-2 adrenoceptor agonists (A2AA) together with local anesthetics (LA) will prolong the duration of peripheral nerve blocks. The standard use of A2AAs for peripheral nerve blockade has recently been recommended also in children, but the evidence base in support of this suggestion has to date been equivocal. The purpose of this meta-analysis was to produce evidence-based data regarding the effect in children. ⋯ This meta-analysis provides evidence-based support for the use of adjunct alpha-2 adrenoceptor agonists when performing peripheral nerve blocks in children.