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Acta Anaesthesiol Scand. 2019 Nov 17. doi: 10.1111/aas.13509. [Epub ahead of print]

Incidence and risk factors of bradycardia in pediatric patients undergoing intranasal dexmedetomidine sedation.

Author information

1
Sedation and Analgesia Center, Kunming Children's Hospital, Kunming, China.
2
Department of Anesthesiology, Kunming Children's Hospital, Kunming, China.
3
Department of Anesthesiology, Second Affiliated Hospital of Kunming Medical University, Kunming, China.

Abstract

BACKGROUND:

Dexmedetomidine is widely used for non-invasive pediatric procedural sedation. However, the hemodynamic effects of intravenous dexmedetomidine are a concern. There has been a growing interest in the application of intranasal dexmedetomidine as a sedative in children.

OBJECTIVE:

To investigate the incidence of bradycardia in children undergoing intranasal dexmedetomidine sedation and to identify the associated risk factors.

METHODS:

Data pertaining to pediatric patients who underwent intranasal dexmedetomidine sedation for non-invasive investigations at the Kunming Children's Hospital between October 2017 and August 2018 were retrospectively analyzed.

RESULTS:

Out of 9984 children who qualified for inclusion, 228 children (2.3%) developed bradycardia. The incidence of bradycardia in the group that received additional dose of dexmedetomidine was higher than that in the group that did not receive additional dose (9.2% vs 16.7%; P = .003). The incidence of bradycardia in males was higher than that in females (2.6% vs 1.8%; P = .007). On multivariate logistic regression, only male gender showed an independent association with the occurrence of bradycardia (odds ratio 1.48; 95% confidence interval 1.11-1.97; P = .008).

CONCLUSIONS:

The overall incidence of bradycardia in children after sole use of intranasal dexmedetomidine sedation was 2.3%. Male children showed a 1.48-fold higher risk of bradycardia. However, the blood pressure of the children who developed bradycardia was within the normal range. Simple wake-up can effectively manage bradycardia induced by intranasal dexmedetomidine sedation.

KEYWORDS:

bradycardia; incidence; intranasal dexmedetomidine; risk factor; sedation

PMID:
31736052
DOI:
10.1111/aas.13509

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