Intramuscular dexmedetomidine: an effective route of sedation preserves background activity for pediatric electroencephalograms.
OBJECTIVE
To describe the efficacy and outcome of dexmedetomidine (Dex) via the intramuscular (IM) route for sedation for electroencephalography (EEG).


METHODS
Quality assurance data and EEG studies were reviewed for consecutive patients who received IM Dex for EEGs between August 2007 and September 2009. Sleep spindles, delta waves, and beta activity were evaluated to determine the deepest stage of sleep achieved.


RESULTS
One hundred seven consecutive children (age 0.2-17 years) between August 2007 and September 2009 received IM Dex (range 1.0-4.5 mcg/kg). The average time to achieve sedation was 15.5 minutes (range 3.0-55.0) with an average of 54.5 minutes to meet discharge criteria following EEG studies, which averaged 34.2 ± 22.6 minutes. The deepest stage of sleep recorded for each child was: awake (n = 1), stage N2 (n = 51), and stage N3 (n = 55). Excessive beta activity was seen in only 1 patient. Epileptiform activity was noted in 11 patients. Hemodynamic fluctuations in heart rate and blood pressure were noted, none of which required pharmacologic intervention. All EEGs were successfully completed.


CONCLUSIONS
We describe Stage 3 sleep and preserved background activity in response to Dex. We present the IM route as a new method, which preserves background EEG activity to provide safe and effective sedation for EEG studies.
Department of Anesthesiology, Boston Children's Hospital, Boston, MA 02115, USA. keira.mason@childrens.harvard.edu
Keira P
KP
Mason
Nina
N
Lubisch
Fay
F
Robinson
Rudolph
R
Roskos
Mark A
MA
Epstein
D000293:Adolescent; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D054810:Deep Sedation / Q000379:methods*; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology; D007223:Infant; D007231:Infant, Newborn; D007273:Injections, Intramuscular / Q000379:methods*; D008297:Male; D010372:Pediatrics / Q000379:methods; D012890:Sleep; D012894:Sleep Stages
D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine