Sedation effects of intranasal dexmedetomidine combined with ketamine and risk factors for sedation failure in young children during transthoracic echocardiography.
Administration, Intranasal
Anesthesia
/ methods
Anesthetics, Dissociative
/ administration & dosage
Child, Preschool
Dexmedetomidine
/ administration & dosage
Echocardiography
/ methods
Female
Humans
Hypnotics and Sedatives
/ administration & dosage
Infant
Infant, Newborn
Ketamine
/ administration & dosage
Male
Retrospective Studies
Risk Factors
dexmedetomidine
ketamine
sedation
transthoracic echocardiography
young children
Journal
Paediatric anaesthesia
ISSN: 1460-9592
Titre abrégé: Paediatr Anaesth
Pays: France
ID NLM: 9206575
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
27
12
2017
revised:
23
09
2018
accepted:
10
10
2018
pubmed:
20
11
2018
medline:
28
7
2019
entrez:
20
11
2018
Statut:
ppublish
Résumé
Sedation is often required for young children during transthoracic echocardiography. Dexmedetomidine and ketamine are two sedatives that are commonly used in children for procedural sedation, but they have some disadvantages when they are used alone. The aim of this retrospective study was to analyze the effects and safety of intranasal sedation with a combination of dexmedetomidine and ketamine during transthoracic echocardiography in young children and to analyze risk factors for sedation failure. After IRB approval, we retrospectively evaluated data on patients who underwent echocardiography between May 2016 and August 2017 utilizing a combination of dexmedetomidine 2 μg/kg and ketamine 1 mg/kg. We collected information including heart rate, pulse oxygen saturation, sedation onset time, exam time, recovery time, and adverse reactions. Stepwise logistic regression analyses were performed to analyze the risk factors for sedation failure. Sedation was successful in 2212 patients (96%) and took effect in 15.7 (IQR: 10-23) min, while sedation failed in 92 patients. Cyanotic heart disease, history of sedation failure, history of congenital heart disease surgery, and fever were independent risk factors for sedation failure. Most of the patients in this study had an American Society of Anesthesiologists (ASA) grade of II to III, but no severe adverse reactions were observed. Intranasal sedation with a combination of dexmedetomidine and ketamine is effective and appears to have an acceptable safety profile for young children during transthoracic echocardiography.
Sections du résumé
BACKGROUND
Sedation is often required for young children during transthoracic echocardiography. Dexmedetomidine and ketamine are two sedatives that are commonly used in children for procedural sedation, but they have some disadvantages when they are used alone.
AIMS
The aim of this retrospective study was to analyze the effects and safety of intranasal sedation with a combination of dexmedetomidine and ketamine during transthoracic echocardiography in young children and to analyze risk factors for sedation failure.
METHODS
After IRB approval, we retrospectively evaluated data on patients who underwent echocardiography between May 2016 and August 2017 utilizing a combination of dexmedetomidine 2 μg/kg and ketamine 1 mg/kg. We collected information including heart rate, pulse oxygen saturation, sedation onset time, exam time, recovery time, and adverse reactions. Stepwise logistic regression analyses were performed to analyze the risk factors for sedation failure.
RESULTS
Sedation was successful in 2212 patients (96%) and took effect in 15.7 (IQR: 10-23) min, while sedation failed in 92 patients. Cyanotic heart disease, history of sedation failure, history of congenital heart disease surgery, and fever were independent risk factors for sedation failure. Most of the patients in this study had an American Society of Anesthesiologists (ASA) grade of II to III, but no severe adverse reactions were observed.
CONCLUSION
Intranasal sedation with a combination of dexmedetomidine and ketamine is effective and appears to have an acceptable safety profile for young children during transthoracic echocardiography.
Substances chimiques
Anesthetics, Dissociative
0
Hypnotics and Sedatives
0
Dexmedetomidine
67VB76HONO
Ketamine
690G0D6V8H
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Pagination
77-84Subventions
Organisme : People's livelihood project of Chongqing science and Technology Commission
ID : 2008JSCX-MSYB0213
Pays : International
Informations de copyright
© 2018 John Wiley & Sons Ltd.