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The Use of Dexmedetomidine in Pediatric Palliative Care: A Preliminary Study

Jamie Burns1, Kevin Jackson1, Kathy A Sheehy1

  • 11 Division of Anesthesiology, Pain, and Perioperative Medicine, Children's National Health System, The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's Research Institute , Washington, DC.

Journal of Palliative Medicine
|February 11, 2017
PubMed

Insights

Dexmedetomidine infusions significantly reduced pain scores in pediatric patients receiving end-of-life care. This palliative care approach showed a trend toward decreased opioid use without adverse hemodynamic effects.

Area of Science:

  • Pediatric Palliative Care
  • Pharmacology
  • Oncology

Background:

  • Pediatric patients with advanced illnesses experience significant distress, including pain and agitation, impacting quality of life.
  • Opioid therapy, while standard, can be ineffective or lead to increased side effects in end-of-life care.
  • Dexmedetomidine, an alpha2-adrenoreceptor agonist, offers sedative and analgesic properties without respiratory depression, potentially reducing opioid needs.

Purpose of the Study:

  • To evaluate the efficacy of dexmedetomidine infusions in pediatric patients with advanced conditions during end-of-life care.
  • To assess the impact of dexmedetomidine on pain and agitation unresponsive to conventional treatments.
  • To determine if dexmedetomidine can reduce opioid requirements in this patient population.

Main Methods:

  • An observational cohort study was conducted in a pediatric hospital.
  • Nine pediatric patients receiving end-of-life care were treated with dexmedetomidine infusions.
  • Primary outcomes measured were pain scores and morphine-equivalent intake.

Main Results:

  • Dexmedetomidine infusions were associated with significant reductions in pain scores (p < 0.001).
  • A trend towards decreased morphine-equivalent intake was observed.
  • No significant hemodynamic changes necessitated vasoactive or anticholinergic agents.

Conclusions:

  • Dexmedetomidine demonstrates potential benefits in managing pain and agitation in pediatric patients during end-of-life care.
  • These findings support the use of dexmedetomidine as an adjunct in pediatric palliative care.
  • Further research is warranted to confirm these preliminary results.
Abstract

Keywords:
agitationpain controlpediatric pain controlpediatric palliative caresymptom control

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