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Updated: Sep 9, 2025

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Published on: February 28, 2025
Dexmedetomidine's effect on neonatal sedation, pain, respiratory status and cardiovascular system
Marjorie M Makoni1, Ivonne Sierra-Strum2, Adrianne R Bischoff3
1Section of Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. marjorie-makoni@ouhsc.edu.
Objective:
To describe the effects of dexmedetomidine on sedation, pain, respiratory status, and hemodynamics in neonates.
Methods:
A retrospective study of 206 infants in a level IV NICU (2016-2021) receiving continuous dexmedetomidine infusion. Pain/sedation scores, BP, vasopressor and inotrope score (VIS), and concomitant sedatives/analgesics (CSA) were recorded before and every 3-4 h for 24 h.
Results:
Median PMA:32 weeks. Hypotension occurred in 26%, primarily in infants <32weeks PMA, correlating with higher VIS and CSA. CSA use significantly predicted vasopressors/inotrope use.
Conclusion:
Dexmedetomidine, with CSA, increases cardiovascular instability in preterm infants who have unique myocardial structure and function and therefore higher vulnerability.
Clinical Trial Registration (If Any):
None (not applicable).
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