EVALUATION OF DEXMEDETOMIDINE AS AN EFFECTIVE AND SAFE AGENT FOR SHORT-TERM PROCEDURAL SEDATION IN NEONATES

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Objective. This study evaluates the efficacy and safety of dexmedetomidine in neonates for short-term procedural sedation. Background. In the neonatal intensive care unit, diagnostic and therapeutic procedures requiring sedation are often performed. Dexmedetomidine has become a more popular treatment option due to its sedative properties and shorter duration of action. Methods. A comprehensive literature evaluation was conducted. All randomized controlled trials, case series, and case reports were included in the evaluation. The literature search produced 112 articles of which 6 articles were selected to evaluate the usefulness of dexmedetomidine as an effective and safe agent for short term procedural sedation in neonates. Results. A prospective study compared dexmedetomidine to midazolam during magnetic resonance imaging (MRI). Dexmedetomidine was administered as a loading dose of 1 μg/kg over 10 minutes followed by an infusion of 0.5 μg/kg/hr. One study evaluated the role of dexmedetomidine as a sole sedative agent for procedures. High dose dexmedetomidine (loading dose of 3 μg/kg with a subsequent infusion rate of 1.5-2 μg/kg/hr) was given. This study found reduced requirement for other adjuvant benzodiazepine sedatives. A study evaluating the hemodynamic effects of dexmedetomidine revealed that IV dexmedetomidine was associated with modest fluctuations in heart rate and blood pressure requiring no pharmacologic intervention. Conclusion. Dexmedetomidine provided adequate sedation with loading doses of 1μg/kg and maintenance infusion of 0.5-0.7 μg/kg/hr without affecting hemodynamics and respiratory status. Thus, dexmedetomidine may be a suitable agent for procedural sedation in neonates. Grants. N/A