REVIEW   Free access

Minerva Anestesiologica 2019 December;85(12):1334-45

DOI: 10.23736/S0375-9393.19.13820-5

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Intranasal dexmedetomidine in pediatrics: update of current knowledge

Maria C. MONDARDINI ¹ ✉, Angela AMIGONI ², Paolo CORTELLAZZI ³, Alessandra DI PALMA ⁴, Cristina NAVARRA ⁵, Sergio G. PICARDO ⁴, Rosa PUZZUTIELLO ⁵, Laura RINALDI ⁶, Francesca VITALE ⁷, Geremia ZITO MARINOSCI ⁸, Giorgio CONTI ⁷

¹ Pediatric Intensive Care Unit, Department of Woman’s, Child’s and Urological Diseases, S. Orsola-Malpighi Polyclinic University Hospital, Bologna, Italy; ² Pediatric Intensive Care Unit, Department of Woman’s and Child’s Health, Padua University Hospital, Padua, Italy; ³ Department of Anesthesia and Intensive Care, Città di Sesto San Giovanni Hospital, Milan, Italy; ⁴ Department of Anesthesia and Critical Care (ARCO), Bambino Gesù Children’s Hospital and IRCCS, Rome, Italy; ⁵ Service of Anesthesia and Critical Care, Department of Anesthesia and Critical Care, Siena University Hospital, Siena Italy; ⁶ Department of Anesthesia and Intensive Care, University Hospital of Modena, Modena, Italy; ⁷ Department of Pediatric Intensive Care and Anesthesia, Sacred Heart Catholic University, Rome, Italy; ⁸ Service of Anesthesia and Critical Care, Department of Anesthesia and Critical Care, Pausilipon Hospital, AORN Santobono Pausilipon, Naples, Italy

Intranasal dexmedetomidine, although still off-label, recently boasted an increasing consensus for different uses, namely, in diagnostic non-painful procedures, in painful procedures and in surgical premedication. However, at present, there is no consensus regarding indications, dosage and timing for administration. This article aims to provide a comprehensive literature analysis and summarize the more recent evidence of research on pediatric intranasal dexmedetomidine, in the effort to better delineate usefulness and limits for each specific indication. In summary, available pediatric evidence confirms efficacy and safety of dexmedetomidine for intranasal administration. Pharmacological profile for the various pediatric ages and procedures still needs quality studies and pharmacokinetic in-depth analysis.

KEY WORDS: Dexmedetomidine; Intranasal administration; Pediatrics; Deep sedation; Premedication