Fifty Percent Effective Dose of Intranasal Dexmedetomidine Sedation for Transthoracic Echocardiography in Children With Cyanotic and Acyanotic Congenital Heart Disease

Objectives: To determine the 50% and 95% effective dose of intranasal dexmedetomidine sedation for transthoracic echocardiography in children with cyanotic and acyanotic congenital heart disease. Design: A prospective, nonrandomized study. Setting: A tertiary care teaching hospital. Participants: Patients younger than 18 months with known or suspected congenital heart disease scheduled for transthoracic echocardiography with sedation. Interventions: Patients were divided into a cyanotic group (blood oxygen saturation <85%) or an acyanotic group (blood oxygen saturation >= 85%). This study used Dixon's up-and-down method sequential allocation design. In both groups, the initial dose of intranasal dexmedetomi- dine was 2 mu g/kg and the gradient of increase or decrease was 0.25 mu g/kg. Measurements and Main Results: The 50% effective dose (95% confidence interval) of intranasal dexmedetomidine sedation for transthoracic echocardiography was 3.2 (2.78-3.55) mu g/kg and 1.9 (1.69-2.06) mu g/kg in the cyanotic and acyanotic groups, respectively. None of the patients experienced significant adverse events. Conclusion: The 50% (95% confidence intervals) effective doses of intranasal dexmedetomidine sedation for transthoracic echocardiography were 3.2 (2.78-3.55) mu g/kg and 1.9 (1.69-2.06) mu g/kg in children with cyanotic and acyanotic congenital heart disease, respectively. (C) 2019 Elsevier Inc. All rights reserved.