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Feasibility of measuring memory response to increasing dexmedetomidine sedation in children
K P Mason1, E R Kelhoffer2,3, R Prescilla4
1Department of Anesthesia, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA keira.mason@childrens.harvard.edu.
Insights
This study shows that children retain memory during dexmedetomidine sedation until shortly before they become unresponsive. Measuring memory and sedation effects in children is feasible, providing insights into dexmedetomidine
Area of Science:
- Pediatric Anesthesiology and Pharmacology
- Cognitive Neuroscience and Memory Research
- Radiological Imaging Sedation Protocols
Background:
- The prospective evaluation of dexmedetomidine's memory effects in pediatric populations is lacking.
- This study addresses the feasibility of assessing memory and sedation responses in children undergoing non-painful radiological imaging.
- Clinical Trial Registration: NCT 02354378.
Purpose of the Study:
- To evaluate the feasibility of measuring memory and sedation responses in children receiving dexmedetomidine.
- To prospectively assess the memory effect of dexmedetomidine in pediatric patients.
- To quantify the relationship between the onset of sedation and memory changes.
Main Methods:
- Administered a 10-minute bolus of dexmedetomidine (2 mcg/kg) to children who named line drawings every 5 seconds.
- Defined absence of sedation as any verbal response, irrespective of accuracy.
- Assessed recognition memory post-recovery using a subsequent memory paradigm, matching recognition to sedation responses.
Main Results:
- Feasibility was demonstrated in 30 children (mean age 6.1 years) who completed all study tasks.
- Children had a 50% probability of verbal response at 5 minutes 40 seconds post-infusion.
- A 50% probability of subsequent recognition memory occurred earlier, at 4 minutes 5 seconds.
Conclusions:
- Quantifying memory and sedation effects of dexmedetomidine in verbal children is feasible.
- Memory function persisted until shortly before verbal unresponsiveness during dexmedetomidine infusion.
- This is the first study to investigate dexmedetomidine's effect on memory in children.
Background:
The memory effect of dexmedetomidine has not been prospectively evaluated in children. We evaluated the feasibility of measuring memory and sedation responses in children during dexmedetomidine sedation for non-painful radiological imaging studies. Secondarily, we quantified changes in memory in relation to the onset of sedation.
Methods:
A 10 min bolus of dexmedetomidine (2 mcg kg-1) was given to children as they named simple line drawings every five s. The absence of sedation was identified as any verbal response, regardless of correctness. After recovery, recognition memory was tested with correct Yes/No recognitions (50% novel pictures) and was matched to sedation responses during the bolus period (subsequent memory paradigm).
Results:
Of 64 accruals, 30 children (mean [SD]6.1 (1.2) yr, eight male) received dexmedetomidine and completed all study tasks. Individual responses were able to be modelled successfully in the 30 children completing all the study tasks, demonstrating feasibility of this approach. Children had 50% probability of verbal response at five min 40 s after infusion start, whereas 50% probability of subsequent recognition memory occurred sooner at four min five s.
Conclusions:
Quantifying memory and sedation effects during dexmedetomidine infusion in verbal children was possible and demonstrated that memory function was present until shortly before verbal unresponsiveness occurred. This is the first study to investigate the effect of dexmedetomidine on memory in children.
Clinical Trial Registration:
NCT 02354378.
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