title: High-dose dexmedetomidine for noninvasive pediatric procedural sedation and discharge readiness.
abstract: BACKGROUND
  The University of North Carolina's (UNC) Pediatric Sedation Service adopted a noninvasive procedural sedation protocol that uses dexmedetomidine in children based on review of literature that reported fast recovery times and low morbidity. This study aimed to compare dexmedetomidine discharge readiness times observed at UNC with those previously published with a hypothesis that the discharge times at UNC are longer than those previously published. A secondary aim was to evaluate the safety profile of the protocol.
  
  
  METHODS
  Pediatric outpatients (6 months-18 years) who received dexmedetomidine per protocol for a noninvasive procedure or study from January 2011 through April 2012 were included in this retrospective chart review. A total of 615 patient encounters were evaluated. Patients received bolus doses of 2 μg·kg(-1) over 10 min for up to three doses followed by a 1 μg·kg(-1) ·h(-1) infusion (group 1) or a 1.5 μg·kg(-1) ·h(-1) infusion (group 2). Primary outcomes included time to sedation, time to arousal, and time to discharge.
  
  
  RESULTS
  No significant differences between the dosing groups were noted. Time to discharge was significantly shorter for group 1 (79 min) than for group 2 (101 min). The range of discharge times at UNC was 78.7-100.9 min compared to previous studies that report recovery times of 24.8-35.2 min.
  
  
  CONCLUSIONS
  Dexmedetomidine arousal and discharge times observed at UNC were longer than anticipated when compared to literature. The safety profile of the drug was comparable to prior studies.
authors.affiliation: Department of Anesthesiology and Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Janey R
authors.initials: JR
authors.lastname: Phelps
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Russell
authors.affiliation: Department of Anesthesiology and Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Lupa
authors.affiliation: Department of Anesthesiology and Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Peggy
authors.initials: P
authors.lastname: McNaull
authors.affiliation: Department of Anesthesiology and Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Pittenger
authors.affiliation: Department of Anesthesiology and Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Karene
authors.initials: K
authors.lastname: Ricketts
authors.affiliation: Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ditto
authors.affiliation: Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Andrey V
authors.initials: AV
authors.lastname: Bortsov
mesh_terms: D000293:Adolescent; D000762:Anesthesia Recovery Period; D002648:Child; D002675:Child, Preschool; D020927:Dexmedetomidine; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D007223:Infant; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine
keywords: dexmedetomidine; moderate sedation; patient discharge; pediatrics; pharmacology; safety drug