Combined sedation in pediatric magnetic resonance imaging: determination of median effective dose of intranasal dexmedetomidine combined with oral midazolam
Abstract Background The exact median effective dose (ED50) of intranasal dexmedetomidine combined with oral midazolam sedation for magnetic resonance imaging (MRI) examination in children remains unknow and the aim of this study was to determine the ED50 of their combination. Methods This is a prosp...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-024-02493-x |
| _version_ | 1797247075282321408 |
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| author | Hao Xie Jialian Zhao Haiya Tu Wenyang Wang Yaoqin Hu |
| author_facet | Hao Xie Jialian Zhao Haiya Tu Wenyang Wang Yaoqin Hu |
| author_sort | Hao Xie |
| collection | DOAJ |
| description | Abstract Background The exact median effective dose (ED50) of intranasal dexmedetomidine combined with oral midazolam sedation for magnetic resonance imaging (MRI) examination in children remains unknow and the aim of this study was to determine the ED50 of their combination. Methods This is a prospective dose-finding study. A total of 53 children aged from 2 months to 6 years scheduled for MRI examination from February 2023 to April 2023 were randomly divided into group D (to determine the ED50 of intranasal dexmedetomidine) and group M (to determine the ED50 of oral midazolam). The dosage of dexmedetomidine and midazolam was adjusted according to the modified Dixon’s up-and-down method, and the ED50 was calculated with a probit regression approach. Results The ED50 of intranasal dexmedetomidine when combined with 0.5 mg∙kg− 1 oral midazolam was 0.39 µg∙kg− 1 [95% confidence interval (CI) 0.30 to 0.46 µg∙kg− 1] while the ED50 of oral midazolam was 0.17 mg∙kg− 1 (95% CI 0.01 to 0.29 mg∙kg− 1) when combined with 1 µg∙kg− 1 intranasal dexmedetomidine. The sedation onset time of children with successful sedation in group D was longer than in group M (30.0[25.0, 38.0]vs 19.5[15.0, 35.0] min, P < 0.05). No other adverse effects were observed in the day and 24 h after medication except one dysphoria. Conclusion This drug combination sedation regimen appears suitable for children scheduled for MRI examinations, offering a more precise approach to guide the clinical use of sedative drugs in children. Trial registration Chinese Clinical Trial Registry, identifier: ChiCTR2300068611(24/02/2023). |
| first_indexed | 2024-04-24T19:52:55Z |
| format | Article |
| id | doaj.art-82dcf88d885a41e6bcde41830f5dbcd3 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-04-24T19:52:55Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-82dcf88d885a41e6bcde41830f5dbcd32024-03-24T12:31:52ZengBMCBMC Anesthesiology1471-22532024-03-012411910.1186/s12871-024-02493-xCombined sedation in pediatric magnetic resonance imaging: determination of median effective dose of intranasal dexmedetomidine combined with oral midazolamHao Xie0Jialian Zhao1Haiya Tu2Wenyang Wang3Yaoqin Hu4Department of Anesthesiology, Children’s Hospital, School of Medicine, Zhejiang UniversityDepartment of Anesthesiology, Children’s Hospital, School of Medicine, Zhejiang UniversityDepartment of Anesthesiology, Children’s Hospital, School of Medicine, Zhejiang UniversityDepartment of Anesthesiology, Children’s Hospital, School of Medicine, Zhejiang UniversityDepartment of Anesthesiology, Children’s Hospital, School of Medicine, Zhejiang UniversityAbstract Background The exact median effective dose (ED50) of intranasal dexmedetomidine combined with oral midazolam sedation for magnetic resonance imaging (MRI) examination in children remains unknow and the aim of this study was to determine the ED50 of their combination. Methods This is a prospective dose-finding study. A total of 53 children aged from 2 months to 6 years scheduled for MRI examination from February 2023 to April 2023 were randomly divided into group D (to determine the ED50 of intranasal dexmedetomidine) and group M (to determine the ED50 of oral midazolam). The dosage of dexmedetomidine and midazolam was adjusted according to the modified Dixon’s up-and-down method, and the ED50 was calculated with a probit regression approach. Results The ED50 of intranasal dexmedetomidine when combined with 0.5 mg∙kg− 1 oral midazolam was 0.39 µg∙kg− 1 [95% confidence interval (CI) 0.30 to 0.46 µg∙kg− 1] while the ED50 of oral midazolam was 0.17 mg∙kg− 1 (95% CI 0.01 to 0.29 mg∙kg− 1) when combined with 1 µg∙kg− 1 intranasal dexmedetomidine. The sedation onset time of children with successful sedation in group D was longer than in group M (30.0[25.0, 38.0]vs 19.5[15.0, 35.0] min, P < 0.05). No other adverse effects were observed in the day and 24 h after medication except one dysphoria. Conclusion This drug combination sedation regimen appears suitable for children scheduled for MRI examinations, offering a more precise approach to guide the clinical use of sedative drugs in children. Trial registration Chinese Clinical Trial Registry, identifier: ChiCTR2300068611(24/02/2023).https://doi.org/10.1186/s12871-024-02493-xCombined sedationIntranasal dexmedetomidineOral midazolamPediatric magnetic resonance imagingMedian effective dose |
| spellingShingle | Hao Xie Jialian Zhao Haiya Tu Wenyang Wang Yaoqin Hu Combined sedation in pediatric magnetic resonance imaging: determination of median effective dose of intranasal dexmedetomidine combined with oral midazolam BMC Anesthesiology Combined sedation Intranasal dexmedetomidine Oral midazolam Pediatric magnetic resonance imaging Median effective dose |
| title | Combined sedation in pediatric magnetic resonance imaging: determination of median effective dose of intranasal dexmedetomidine combined with oral midazolam |
| title_full | Combined sedation in pediatric magnetic resonance imaging: determination of median effective dose of intranasal dexmedetomidine combined with oral midazolam |
| title_fullStr | Combined sedation in pediatric magnetic resonance imaging: determination of median effective dose of intranasal dexmedetomidine combined with oral midazolam |
| title_full_unstemmed | Combined sedation in pediatric magnetic resonance imaging: determination of median effective dose of intranasal dexmedetomidine combined with oral midazolam |
| title_short | Combined sedation in pediatric magnetic resonance imaging: determination of median effective dose of intranasal dexmedetomidine combined with oral midazolam |
| title_sort | combined sedation in pediatric magnetic resonance imaging determination of median effective dose of intranasal dexmedetomidine combined with oral midazolam |
| topic | Combined sedation Intranasal dexmedetomidine Oral midazolam Pediatric magnetic resonance imaging Median effective dose |
| url | https://doi.org/10.1186/s12871-024-02493-x |
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