Intranasal dexmedetomidine vs oral triclofos sodium for sedation of children with autism undergoing electroencephalograms

Eytan Kaplan*, Adi Shifeldrim, Dror Kraus, Avichai Weissbach, Gili Kadmon, Rachel Milkh, Elhanan Nahum

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Sedation may be necessary for performing electroencephalograms in children with autistic spectrum disorder, however, our sedation success rate using triclofos sodium (TFS) is limited. Intra-nasal dexmedetomidine (IN-DEX) may be a superior sedative for these children. Objective: Compare IN-DEX with TFS for sedation efficacy, resistance to drug delivery and adverse events in children with autism undergoing an electroencephalogram. Study design: A single center, prospective observational study of children with autism sedated for electroencephalograms using IN-DEX compared to an age matched, historic group of children with autism, sedated for electroencephalograms using TFS. Results: Characteristics of 41 IN-DEX sedations were compared to 41 TFS sedations in 82 ASD children. Epileptiform discharges were demonstrated in 23/82 (28%) of children in the cohort. Sedation depth by UMSS was significantly deeper in the IN-DEX group (2.49 ± 0.78 vs. 1.41 ± 0.89, p < 0.001). Electroencephalogram quality demonstrated less motion artifact in the IN-DEX group (1.75 ± 0.76 vs. 2.18 ± 0.88, p < 0.001). The rate of very poor or sedation failure was significantly lower in the IN-DEX group (17% vs 56.1%, p < 0.001), RR = 0.3 (95% CI 0.15 to 0.63, p < 0.001). No major adverse events were documented in either group. Bradycardia occurred in 8/41(19.5%) of children in IN-DEX group and none in TFS group (p = 0.003). Hypotension or poor perfusion were not demonstrated in either group. Conclusion: In children with autism undergoing electroencephalograms, IN-DEX was more tolerable than TFS, induced deeper sedation with a greater success rate, and improved electroencephalogram quality. Both sedatives were equally safe in this population.

Original languageEnglish
Pages (from-to)19-24
Number of pages6
JournalEuropean Journal of Paediatric Neurology
Volume37
DOIs
StatePublished - Mar 2022

Keywords

  • Autistic spectrum disorder
  • Dexmedetomidine
  • Electroencephalography
  • Pediatric sedation
  • Triclofos-sodium

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