The use of dexmedetomidine to facilitate opioid and benzodiazepine detoxification in an infant.
Prolonged use of opioids and benzodiazepines for the care of critically ill infants and children can generate physical dependence. We present a case of an 8-mo-old infant with Hunter's syndrome who was maintained on very large doses of fentanyl and midazolam and who could not be weaned from these drugs by conventional taper. We used dexmedetomidine, an alpha(2)-adrenergic agonist, to facilitate opioid and benzodiazepine withdrawal. A processed electroencephalogram (Bispectral Index) was used to guide the titration of dexmedetomidine in this neurologically impaired infant. This is the first report of this drug being used in an infant to manage chemical dependence withdrawal.


CONCLUSIONS
Dexmedetomidine was used to facilitate opioid and benzodiazepine withdrawal in an 8-mo-old infant. A processed electroencephalogram (Bispectral Index) was used to guide the titration of dexmedetomidine in this neurologically impaired infant. This is the first report of dexmedetomidine use in an infant to manage chemical dependence withdrawal.
Finkel
Julia C
JC
Department of Anesthesiology, Children's National Medical Center and George Washington University, Washington, DC.
Elrefai
Ahmed
A
D000701:Analgesics, Opioid / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000493:pharmacokinetics / Q000627:therapeutic use*; D020927:Dexmedetomidine / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004569:Electroencephalography / Q000187:drug effects / Q000379:methods; D006801:Humans; D008658:Inactivation, Metabolic / Q000502:physiology; D007223:Infant; D008297:Male; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology
D000701:Analgesics, Opioid; D001569:Benzodiazepines; D020927:Dexmedetomidine