Table. Summary of Patient, Procedure, and Sedation Characteristicsa.
| Characteristic | No. (%) |
|---|---|
| Age, median (IQR), y | 7.2 (4.5-11.4) |
| Sex | |
| Male | 31 (72) |
| Female | 12 (28) |
| Diagnosis (patient may have ≥1) | |
| Autism spectrum disorder | 29 (67) |
| Developmental delay NOS | 10 (23) |
| Epilepsy with associated developmental delay | 7 (16) |
| Behavioral disorder NOS | 4 (10) |
| Associated genetic or congenital disorder | 8 (19) |
| Complex congenital heart disease | 2 (5) |
| Chromosome 18q22 anomaly | 1 (2) |
| Turner syndrome | 1 (2) |
| Creatine-synthesis deficiency | 1 (2) |
| MEN2a syndrome | 1 (2) |
| Moebius syndrome | 1 (2) |
| Tuberous Sclerosis | 1 (2) |
| Treated with protocol ≥1 time | |
| 2 Times | 7 (17) |
| 3 Times | 1 (2) |
| Weight for age, median (IQR), percentile | 75 (31-98) |
| Receiving a psychotropic medication (eg, aripiprazole, risperidone, or an amphetamine) | 14 (33) |
| Tolerated EMLA placement at home for blood draw, No./total No. with blood draw (%) | 31/38 (82) |
| Type of procedure (n = 42) | |
| Blood draw | 38 (88) |
| Electrocardiogram | 22 (51) |
| Immunization or other IM injection | 15 (35) |
| Dental examination | 5 (12) |
| Abdominal or cardiac ultrasonographic imaging | 3 (7) |
| Lumbar puncture | 2 (5) |
| Nasofibroscopy | 2 (5) |
| Auditory evoked potentials | 2 (5) |
| Suture removal | 2 (5) |
| Balloon gastrostomy button replacement | 1 (2) |
| Optic nerve examination | 1 (2) |
| Procedures performed during a sedation, No. | |
| 1 | 11 (26) |
| 2 | 15 (36) |
| 3 | 12 (29) |
| 4 | 3 (7) |
| Indication for procedure (patient may have ≥1) | |
| General health maintenance | 29 (68) |
| Investigation of symptoms | 13 (30) |
| Monitor psychotropic medication effects | 11 (26) |
| Prior to starting a psychotropic medication | 2 (5) |
| Sedation characteristics, mean (95% CI), min | |
| Time from IN dexmedetomidine administration to onset of sedation (RSS 5) | 28 (15-45) |
| Duration of n2o administration | 18 (5-35) |
| Time from IN dexmedetomidine administration to awakening (RSS 2) | 106 (80-181) |
| Time from IN dexmedetomidine administration to readiness for discharge (modified Aldrete of 9-10)a | 132 (93-238) |
| Restraint during procedureb | 3 (7) |
| Procedure aborted for suboptimal sedation | 1 (2) |
| Adverse events | |
| During sedation | |
| Intermediatec | 0 |
| Sentinelc | 0 |
| Prolonged sedation (>180 min to RSS 2) | 3 (7) |
| Vomiting | 1 (2) |
| Seizure not requiring intervention (in a patient known to seize multiple times a day) | 1 (2) |
| Reported at 24-hour phone call | |
| Slept later than usual the night of sedation | 35 (81) |
| Agitation | 1 (2) |
| Parental satisfactiond | |
| 4 | 1 (2) |
| 5 | 42 (98) |
Abbreviations: EMLA, eutectic mixture of local anesthetics; IM, intramuscular; IN, intranasal; n2o, nitrous oxide; NOS, not otherwise specified; RSS, Ramsay Sedation Scale.
a
Details on the RSS are provided in eTable 1 in Supplement 1 and details on the Aldrete score are provided in eTable 2 in Supplement 1.
b
Children requiring restraint were ages 2, 7, and 16 years.
c
Defined per the International Committee for the Advancement of Procedural Sedation Tracking and Reporting Outcomes of Procedural Sedation.
d
On a scale of 0, indicating very dissatisfied, to 5, very satisfied.