Intranasal Dexmedetomidine: Efficacy and Safety as a Single Agent for Noninvasive Interventions among Pediatric Patients

Abstract Intranasal dexmedetomidine has become increasingly utilized for pediatric patients. The purpose of this work is to evaluate the efficacy and safety of intranasal dexmedetomidine, as a monotherapy and administered by pediatric intensivists, for a variety of interventions among pediatric patients, as there are limited studies describing this in the literature. This was a retrospective analysis of pediatric patients (outpatient, inpatient floor, and critical care statuses) undergoing noninvasive interventions between July 5, 2017 and July 5, 2022. The primary outcome of interest was the type and number of adverse events (respiratory, cardiovascular, neurological, and patient intolerance events). The secondary outcome was the length of sedation. Additional data of interest included age, length of recovery, and type of intervention. There were 59 sedations completed using intranasal dexmedetomidine as a single agent. No adverse events were observed. The median age of patients was 14 months (interquartile range [IQR]: 8.50–26.50 months). The median sedation time was 69 minutes (IQR: 57.5–87.5) and 75% of the patients recovered within 43 minutes. The majority of patients (54%) underwent computed tomography scans, but additional interventions ranged from auditory brainstem response evaluations to echocardiograms. Intranasal dexmedetomidine seems to be a safe and effective monotherapy for noninvasive interventions in the pediatric population and can be administered by pediatric intensivists.