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Intranasal Dexmedetomidine for Procedural Sedation in Children, a Suitable Alternative to Chloral Hydrate

Giorgio Cozzi1, Stefania Norbedo2, Egidio Barbi2

  • 1Emergency Department, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", via dell'Istria 65/1, 34132, Trieste, Italy. giorgiocozzi@gmail.com.

Paediatric Drugs
|March 10, 2017
PubMed

Insights

Chloral hydrate, a common sedative for children, is now banned in some countries due to safety concerns. Intranasal dexmedetomidine offers a safer and equally effective alternative for pediatric procedural sedation.

Area of Science:

  • Pediatric Sedation
  • Pharmacology
  • Anesthesiology

Background:

  • Chloral hydrate has been a widely used sedative for pediatric diagnostic procedures for decades.
  • Recent bans in Italy and France highlight concerns regarding chloral hydrate's carcinogenicity and genotoxicity.
  • Dexmedetomidine is an emerging sedative with a favorable safety profile for pediatric procedural sedation.

Purpose of the Study:

  • To evaluate intranasal dexmedetomidine as a safer alternative to chloral hydrate for pediatric procedural sedation.
  • To compare the efficacy and safety of intranasal dexmedetomidine with chloral hydrate in children undergoing non-painful procedures.

Main Methods:

  • Review of studies comparing intranasal dexmedetomidine and chloral hydrate for pediatric procedural sedation.
  • Analysis of efficacy and safety data, including impact on respiratory drive and airway patency.

Main Results:

  • Dexmedetomidine demonstrates efficacy and safety in pediatric procedural sedation.
  • Intranasal administration of dexmedetomidine is associated with satisfactory procedural success rates.
  • Comparative studies indicate dexmedetomidine is as effective and safer than chloral hydrate for non-painful procedures in children.

Conclusions:

  • Intranasal dexmedetomidine presents a viable and safer alternative to chloral hydrate for pediatric procedural sedation.
  • The unique properties of dexmedetomidine, including minimal impact on respiratory function, support its use.
  • Regulatory actions against chloral hydrate further support the adoption of dexmedetomidine in pediatric practice.

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