Determination of median effective dose for intranasal dexmedetomidine sedation in children undergoing electroencephalography

Xinxin ZHENG; Jianxia LIU; Min DU; Ying XU

doi:10.16016/j.1000-5404.201712233

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Determination of median effective dose for intranasal dexmedetomidine sedation in children undergoing electroencephalography

Clinical Medicine | 更新时间：2026-01-09

- Determination of median effective dose for intranasal dexmedetomidine sedation in children undergoing electroencephalography
- Journal of Third Military Medical University Vol. 40, Issue 14, Pages: 1321-1324(2018)
- 作者机构：
  
  1.400014 重庆，重庆医科大学附属儿童医院麻醉科, 儿童发育疾病研究教育部重点实验室，儿童发育重大疾病国家国际科技合作基地，儿科学重庆市重点实验室
  2.401331 重庆，重庆医科大学附属大学城医院麻醉科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201712233
  CLC： R451;R741.044;R971.3
- Received：25 December 2017，
  
  Revised：2018-03-09，
  
  Published：30 July 2018
- 稿件说明：
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Xinxin ZHENG, Jianxia LIU, Min DU, et al. Determination of median effective dose for intranasal dexmedetomidine sedation in children undergoing electroencephalography[J]. Journal of Third Military Medical University, 2018, 40(14): 1321-1324.
DOI：

Xinxin ZHENG, Jianxia LIU, Min DU, et al. Determination of median effective dose for intranasal dexmedetomidine sedation in children undergoing electroencephalography[J]. Journal of Third Military Medical University, 2018, 40(14): 1321-1324. DOI： 10.16016/j.1000-5404.201712233.

摘要

目的

探讨右美托咪定滴鼻镇静用于小儿脑电图检查的半数有效剂量。

方法

纳入重庆医科大大学附属儿童医院2016年10月25日至2017年10月25日，拟行右美托咪定滴鼻镇静下睡眠脑电图检查患儿39例，年龄1~6岁，ASAⅠ~Ⅱ级。采用双盲、序贯的前瞻性研究方法进行试验，根据预试验结果确定初始剂量为2.0 μg/kg，将患儿Ramsay镇静评分(Ramsay sedation scale

RSS)评分≥4分和睫毛反射消失作为有效镇静标准，由上1例患儿的镇静情况，决定下1例患儿的滴鼻剂量，按0.2 μg/kg阶梯增减。将RSS评分≥4分且睫毛反射消失的患儿纳入镇静有效组，RSS评分＜4分的患儿纳入镇静无效组。每10分钟记录1次患儿的呼吸频率、心率、血压和血氧饱和度，研究进行至阴性、阳性结果达到8个拐点时终止试验。

结果

右美托咪定滴鼻用于小儿脑电图检查的半数有效剂量(50% effective dose，ED

)为2.10 μg/kg，95%可信区间(confidence interval，

)为(1.955~2.255)μg/kg。

结论

2.10 μg/kg右美托咪定滴鼻可使50%脑电图检查患儿达到有效镇静状态，不干扰痫样放电检出，镇静效果满意，对呼吸和循环系统影响较小。

Abstract

Objective

To determine the median effective dose (ED50) for intranasal dexmedetomidine sedation in children undergoing electroencephalographic recording.

Methods

Thirty-nine children (aged 1~6 years

American Society of Anesthesiologists class Ⅰ~Ⅱ) were enrolled in this study to receive intranasal dexmedetomidine sedation for electroencephalographic recording in the Children's Hospital of Chongqing Medical University between October 25

2016 and October 25

2017. This trial was conducted using a double-blind

sequential

and prospective design. According to the preliminary trial results

the starting intranasal dexmedetomidine dose was determined at 2.0 μg/kg for sedation. Effective sedation was defined as a Ramsay Sedation Scale (RSS) score of at least 4 with the loss of eyelash reflex. Based on the condition of sedation in the previous patient

the intranasal dose for the next patient was adjusted with a gradient of 0.2 μg/kg. For each child

the respiratory frequency

heart rate

blood pressure and oxygen saturation were recorded every 10 min after the sedation

and the trial was terminated when the negative and positive results reached 8 inflection points.

Results

The ED50 of intranasal dexmedetomidine for sedation in children for electroencephalography was 2.10 μg/kg with a 95% confidence interval of 1.955~2.255 μg/kg.

Conclusion

Intranasal administration of dexmedetomidine at the dose of 2.10 μg/kg can achieve effective sedation in 50% of the children undergoing electroencephalographic examination without interfering with the detection of epileptic discharges or producing obvious adverse effects on the respiratory and circulatory systems.

关键词

Keywords

references

SENEVIRATNE U, COOK M J, D'SOUZA W J. Electroencephalography in the diagnosis of genetic generalized epilepsy syndromes[J]. Front Neurol, 2017, 8: 499. DOI:10.3389/fneur.2017.00499.

KEIDAN I, BEN-MENACHEM E, TZADOK M, et al. Electroencephalography for children with autistic spectrum disorder: a sedation protocol[J]. Paediatr Anaesth, 2015, 25(2): 200-205. DOI: 10.1111/pan.12510.

CHAITANYA G, ARIVAZHAGAN A, SINHA S, et al. Dexmedetomidine anesthesia enhances spike generation during intra-operative electrocorticography: a promising adjunct for epilepsy surgery[J]. Epilepsy Res, 2015, 109: 65-71. DOI: 10.1016/j.eplepsyres.2014.10. 006.

MASON K P, O'MAHONY E, ZURAKOWSKI D, et al. Effects of dexmedetomidine sedation on the EEG in children[J]. Paediatr Anaesth, 2009, 19(12): 1175-1183. DOI: 10.1111/j.1460-9592.2009.03160.x.

奚晓雁, 肖宇, 周淑辉.右美托咪定滴鼻镇静术预防儿童牙科焦虑症的有效剂量分析[J].海南医学, 2017, 28(8): 1260-1262. DOI:10.3969/j.issn.1003-6350.2017.08.019.

XI X Y, XIAO Y, ZHOU S H. Effective dose of dexmedetomidine nasal sedation in prevention of dental anxiety disorder in children[J].Hainan Med J, 2017, 27(8): 1260-1262.DOI: 10.3969/j.issn.1003-6350.2017.08.019.

RAMASWAMY S S, PARIMALA B. Comparative evaluation of two different loading doses of dexmedetomidine with midazolam-fentanyl for sedation in vitreoretinal surgery under peribulbar anaesthesia[J]. Indian J Anaesth, 2016, 60(2): 89-93. DOI: 10.4103/ 0019-5049.176277.

徐颖怡, 宋兴荣, 张国强.右美托咪啶滴鼻诱导CT检查患儿睡眠的半数有效剂量[J].中华医学杂志, 2014, 94(24): 1886-1888. DOI:10.3760/cma.j.issn.0376-2491.2014.24.012.

XU Y Y, SONG X R, ZHANG G Q. ED50 dexmedetomidine nasal drip in induction of hypnosis in children during computed tomography[J]. Natl Med J China, 2014, 94(24): 1886-1888. DOI: 10.3760/cma.j.issn.0376-2491.2014. 24.012.

DIXON W J, MASSEY F J. Introduction to statistical analysis[M].4thed, New York: McGraw-Hill, 1983: 426-441.

许幸, 魏秀兰, 吴新民.序贯试验法测定异丙酚诱导时的BIS50和ED50[J].中华麻醉学杂志, 2001, 21(1): 7-9. DOI:10.3760/j.issn:0254-1416.2001.01.002.

XU X, WEI X L, WU X M. Determination of BIS50 and ED50 forpropofol during induction by sequential experimental method[J].Chin J Anesthesia, 2001, 21(1): 7-9. DOI:10.3760/j.issn: 0254-1416.2001.01.002.

YUEN V M, LI B L, CHEUK D K, et al. A randomised controlled trial of oral chloral hydrate vs. intranasal dexmedetomidine before computerised tomography in children[J]. Anaesthesia, 2017, 72(10): 1191-1195. DOI: 10.1111/anae.13981.

COZZI G, NORBEDO S, BARBI E. Intranasal dexmedetomidine for procedural sedation in children, a suitable alternative to chloral hydrate[J]. Paediatr Drugs, 2017, 19(2): 107-111. DOI: 10.1007/s40272-017-0217-5.

GUMUS H, BAYRAM A K, POYRAZOGLU H G, et al. Comparison of effects of different dexmedetomidine and chloral hydrate doses used in sedation on electroencephalography in pediatric patients[J]. J Child Neurol, 2015, 30(8): 983-988. DOI: 10.1177/ 0883073814549582.

MAHMOUD M, MASON K P. Dexmedetomidine: review, update, and future considerations of paediatric perioperative and periprocedural applications and limitations[J]. Br J Anaesth, 2015, 115(2): 171-182. DOI: 10.1093/bja/aev226.

PURDON P L, SAMPSON A, PAVONE K J, et al. Clinical electroencephalography for anesthesiologists: Part I: background and basic signatures[J]. Anesthesiology, 2015, 123(4): 937-960. DOI: 10.1097/ALN.0000000000000841.

KIM W H, CHO D, LEE B, et al. Changes in brain activation during sedation induced by dexmedetomidine[J]. J Int Med Res, 2017, 45(3): 1158-1167. DOI: 10.1177/ 0300060517705477.

IIROLA T, VILO S, MANNER T, et al. Bioavailability of dexmedetomidine after intranasal administration[J]. Eur J Clin Pharmacol, 2011, 67(8): 825-831. DOI: 10.1007/s00228-011-1002-y.

TUG A, HANCI A, TURK H S, et al. Comparison of two different intranasal doses of dexmedetomidine in children for magnetic resonance imaging sedation[J]. Paediatr Drugs, 2015, 17(6): 479-485. DOI: 10.1007/s40272-015-0145-1.

FERNANDES M L, OLIVEIRA W M, SANTOS MDO C, et al. Sedation for electroencephalography with dexmedetomidine or chloral hydrate: a comparative study on the qualitative and quantitative electroencephalogram pattern[J]. J Neurosurg Anesthesiol, 2015, 27(1): 21-25. DOI: 10.1097/ANA.0000000000000077.

杨晓燕, 龙莉莉, 肖波.视频脑电图在儿童癫癎诊断及定位中的作用[J].中国当代儿科杂志, 2016, 18(10): 971-974. DOI:10.7499/j.issn.1008-8830.2016.10.010.

YANG X Y, LONG L L, XIAO B. Role of video electroencephalogram in diagnosis and localization of epilepsy in children [J].Chin J Contemp Pediatr, 2016, 18(10): 971-974. DOI: 10.7499/j.issn.1008-8830.2016.10.010.

LIU Y, YU Q, SUN M, et al. Median effective dose of intranasal dexmedetomidine sedation for transthoracic echocardiography examination in postcardiac surgery and normal children: An up-and-down sequential allocation trial[J]. Eur J Anaesthesiol, 2018, 35: 1. DOI: 10.1097/EJA. 0000000000000724.

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