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Intravenous dexmedetomidine sedation for magnetoencephalography: A retrospective study
Author(s) -
Tewari Anurag,
Mahmoud Mohamed,
Rose Douglas,
Ding Lili,
Tenney Jeffrey
Publication year - 2020
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.13925
Subject(s) - dexmedetomidine , magnetoencephalography , sedation , medicine , anesthesia , electroencephalography , ictal , epilepsy , epilepsy surgery , retrospective cohort study , surgery , psychiatry
Background Magnetoencephalography (MEG) plays a preponderant role in the preoperative assessment of patients with drug‐resistant epilepsy (DRE). However, the magnetoencephalography of patients with drug‐resistant epilepsy can be difficult without sedation and/or general anesthesia. Our objective is to describe our experience with intravenous dexmedetomidine as sedation for magnetoencephalography and its effect, if any, on the ability to recognize epileptic spikes. Methods In this retrospective study, we reviewed the records of 89 children who presented for Magnetoencephalography/electroencephalography (EEG) scans between August of 2008 and May of 2015. Data analyzed included demographics and the frequency of epileptic spikes. Sedated magnetoencephalography recordings were compared to nonsedated video‐electroencephalography (vEEG) recordings in the same patients to determine the impact of dexmedetomidine. Results Spike frequency between magnetoencephalography with sedation and video‐electroencephalography without sedation was compared in 85 patients. Magnetoencephalography and video‐electroencephalography were considered clinically concordant in 80 patients (94.1%) and discordant in 5 patients (5.9%), all with less spikes during Magnetoencephalography. The median (range) bolus dose of dexmedetomidine was 2 (1‐2) mcg/kg. The median (range) infusion rate of dexmedetomidine was 2 (0.5‐4) mcg/kg/h. All patients experienced reductions in heart rate after administration of dexmedetomidine; these reductions were statistically, but not clinically, significant. Conclusions Our results suggest that dexmedetomidine‐based protocol provides reliable sedation in children undergoing MEG scanning because of the high success rate, limited interictal artifacts, and minimal impacts on spike frequency.