Intra-nasal dexmedetomidine superior option for sedation in autistic children undergoing EEG

Sedation may be necessary for performing electroencephalograms in children with autistic spectrum disorder, however, our sedation success rate using triclofos sodium (TFS) is limited. Intranasal dexmedetomidine (IN-DEX) may be a superior sedative for these children.

A study was conducted to compare IN-DEX with TFS for sedation efficacy, resistance to drug delivery and adverse events in children with autism undergoing an electroencephalogram.

A single centre, 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
• Electroencephalogram quality demonstrated less motion artefact in the IN-DEX group
• The rate of very poor or sedation failure was significantly lower in the IN-DEX group
• 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.

Thus, 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.

Reference:

Intranasal dexmedetomidine vs oral triclofos sodium for sedation of children with autism undergoing electroencephalograms by Eytan Kaplan et al. published in the European Journal of Pediatric Neurology

DOI: https://doi.org/10.1016/j.ejpn.2022.01.005