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The 90% effective dose of intranasal dexmedetomidine for procedural sedation in children with congenital heart disease before and after surgery: A biased‐coin design up‐and‐down sequential allocation trial
Author(s) -
Zhang Jing,
Chen YuJiao,
Li ShangYingYing,
Liu Hui,
Tu ShengFen
Publication year - 2021
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.13693
Subject(s) - dexmedetomidine , medicine , sedation , anesthesia , cardiac surgery , nasal administration , adverse effect , heart disease , surgery , cardiology , immunology
Background Intranasal dexmedetomidine can provide adequate sedation during short procedures. However, there are few reports investigating the effective dose of intranasal dexmedetomidine for sedation in children with congenital heart disease (CHD) before and after surgery. Methods Children aged 13‐36 months with acyanotic CHD requiring trans‐thoracic echocardiography before cardiac surgery were recruited for this study. One month after the cardiac surgery, the same children were studied again. The 90% effective dose was established using a biased‐coin design up‐and‐down sequential method. Onset time, examination time, wake‐up time and adverse effects were measured. Safety was evaluated in terms of changes in vital signs. Results A total of fifty‐eight subjects were recruited for this study. The 90% effective dose of intranasal dexmedetomidine for sedation was 2.13 μg/kg (95% CI, 1.73‐2.34 μg/kg) in children with CHD before cardiac surgery and 3.51 μg/kg (95% CI, 2.99‐3.63 μg/kg) after cardiac surgery ( P < .01). There were no differences between the groups in terms of demographic variables, onset time, examination time, wake‐up time or adverse effects. Conclusions The 90% effective dose of intranasal dexmedetomidine for sedation in children with CHD was 2.13 μg/kg before cardiac surgery and 3.51 μg/kg after cardiac surgery.