title: Pediatric Procedural Sedation Using Dexmedetomidine: A Report From the Pediatric Sedation Research Consortium.
abstract: Dexmedetomidine (DEX) is widely used in pediatric procedural sedation (PPS) by a variety of pediatric subspecialists. The objective of our study was to describe the overall rates of adverse events and serious adverse events (SAEs) when DEX is used by various pediatric subspecialists.
  
  
  
  Patients from the Pediatric Sedation Research Consortium (PSRC) database were retrospectively reviewed and children that received DEX as their primary sedation agent for elective PPS were identified. Demographic and clinical data, provider subspecialty, and sedation-related complications were abstracted. SAEs were defined as death, cardiac arrest, upper airway obstruction, laryngospasm, emergent airway intervention, unplanned hospital admission/increased level of care, aspiration, or emergency anesthesia consult. Event rates and 95% confidence intervals (CIs) were calculated.
  
  
  
  During the study period, 13 072 children were sedated using DEX, accounting for 5.3% of all sedation cases entered into the PSRC. Of the sedated patients, 73% were American Society of Anesthesiologists Physical Status class 1 or 2. The pediatric providers responsible for patients sedated with DEX were anesthesiologists (35%), intensivists (34%), emergency medicine physicians (12.7%), hospitalists (1.1%), and others (17%). The overall AE rate was 466/13 072 (3.6%, 95% CI 3.3% to 3.9%). The overall SAE rate was 45/13 072 (0.34%, 95% CI 0.19% to 0.037%). Airway obstruction was the most common SAE: 35/13 072 (0.27%, 95% CI 0.19% to 0.37%). Sedations were successful in 99.7% of cases.
  
  
  
  We report the largest series of PPS using DEX outside the operating room. Within the PSRC, PPS performed using DEX has a very high success rate and is unlikely to yield a high rate of SAEs.
authors: Department of Pediatrics, and.
authors: Carmen
authors: C
authors: Sulton
authors: Department of Pediatrics, and.
authors: Courtney
authors: C
authors: McCracken
authors: Department of Pediatrics, and Divisions of Pediatric Emergency Medicine and.
authors: Harold K
authors: HK
authors: Simon
authors: Department of Pediatrics, and Pediatric Critical Care Medicine, Emory University School of Medicine, Atlanta, Georgia;
authors: Kiran
authors: K
authors: Hebbar
authors: Department of Pediatrics, Baylor College of Medicine, San Antonio, Texas;
authors: Jason
authors: J
authors: Reynolds
authors: Department of Anesthesiology, Boston Children's Hospital, Boston, Massachusetts; and.
authors: Joseph
authors: J
authors: Cravero
authors: Pediatric Emergency Medicine Associates, Children's Healthcare of Atlanta, Atlanta, Georgia.
authors: Michael
authors: M
authors: Mallory
authors: Department of Pediatrics, and Pediatric Critical Care Medicine, Emory University School of Medicine, Atlanta, Georgia; pradip.kamat@choa.org.
authors: Pradip
authors: P
authors: Kamat
mesh_terms: D002170:Canada; D002675:Child, Preschool; D016292:Procedural Sedation / Q000706:statistics & numerical data; D016208:Databases, Factual; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D061214:Patient Safety; D012189:Retrospective Studies; D014481:United States
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine