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Comparison Between Intranasal vs Intravenous Dexmedetomidine for EEG Sedation of Children With Behavior Disorders.

Completed
Conditions
Sedation Complication
Interventions
Registration Number
NCT06434428
Lead Sponsor
Azienda Ospedaliera di Padova
Brief Summary

The aim of the project was to compare the efficacy and safety of intranasal (IN) and intravenous (IV) dexmedetomidine (DEX) in procedural sedation for electroencephalogram (EEG) in pediatric patients with behavioural disorders.

Single-centre comparative observational study in the tertiary care centre of Padua, regarding all consecutive pediatric patients affected by behavioural disorders, who needed sedation for EEG recording. A group of children received IV administration of DEX, the following year a second group of children received IN administration of the same drug. Target of sedation was level 2, according to the Paediatric Sedation State Scale (PSSS).

Detailed Description

OBJECTIVE: The aim of the project was to compare the efficacy and safety of intranasal (IN) and intravenous (IV) dexmedetomidine (DEX) in procedural sedation for electroencephalogram (EEG) in pediatric patients with behavioural disorders.

METHODS: Single-centre comparative observational study in the tertiary care centre of Padua, regarding all consecutive patients \< 18 years old affected by behavioural disorders, who needed sedation for EEG recording. From 2018 to 2020 a group of children received IV administration of DEX (IV DEX), the following year a second group of children received IN administration of the same drug (IN DEX). In both groups, target of sedation was level 2, according to the Paediatric Sedation State Scale (PSSS). Heart rate (HR), pulse oxygen saturation and blood pressure (BP) were registered. EEG recording quality and caregivers' satisfaction were collected.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
48
Inclusion Criteria
  • children affected by behavioural disorders, who need sedation to perform EEG
  • American Society of Anaesthesiologists (ASA) status < 3
  • Written informed consent by a parent or legal guardian.
Exclusion Criteria
  • previous hypersensitivity reaction or contraindications to administration of DEX (cardiac failure, cardiac arrhythmias, long QT syndrome, bradycardia, hypotension, use of beta-blockers or digoxin, uncontrolled arterial hypertension, recent stroke or intracranial bleeding, Moya-Moya syndrome)
  • for IN administration, children with runny nose/mild respiratory infection

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
IN DEXdexmedetomidine (IN)For the IN administration, after a first bolus of 4 mcg/kg it is possible to repeat boluses of 1-2mcg/kg of DEX (maximum dose for each administration is 200mcg). The drug dose is divided into two equal aliquots, with one aliquot administered into each nostril by a nurse using an atomizer device.
IV DEXdexmedetomidine (IV)Patients treated intravenously receives a bolus of DEX (2 mcg/kg over ten minutes), followed by continuous infusion (1-2 mcg/kg/hour), stopped at the end of the procedure. The bolus could be repeated up to three times to reach the optimal target level of sedation before starting the continuous infusion.
Primary Outcome Measures
NameTimeMethod
efficacy (PSSS level 2)20 minutes after dexmedetomidine administration

the patient reaches the level 2 of the Pediatric Sedation State Scale

Secondary Outcome Measures
NameTimeMethod
safety (Sat > 90%; change < 25% of heart frequency and systemic pressure values)during the procedure

presence of adverse events (desaturation, bradycardia, tachycardia, hypertension, hypotension)

Trial Locations

Locations (1)

University Hospital of Padova

🇮🇹

Padova, Italy

University Hospital of Padova
🇮🇹Padova, Italy

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