We investigated the efficacy and complication profile of intranasal dexmedetomidine for transthoracic echocardiography sedation in patients with single ventricle physiology and shunt-dependent pulmonary blood flow during the high-risk interstage period.

A single-centre, retrospective review identified interstage infants who received dexmedetomidine for echocardiography sedation. Baseline and procedural vitals were reported. Significant adverse events related to sedation were defined as an escalation in care or need for any additional/increased inotropic support to maintain pre-procedural haemodynamics. Minor adverse events were defined as changes from baseline haemodynamics that resolved without intervention. To assess whether sedation was adequate, echocardiogram reports were reviewed for completeness.

From September to December 2020, five interstage patients (age 29–69 days) were sedated with 3 mcg/kg intranasal dexmedetomidine. The median sedation onset time and duration time was 24 minutes (range 12–43 minutes) and 60 minutes (range 33–60 minutes), respectively. Sedation was deemed adequate in all patients as complete echocardiograms were accomplished without a rescue dose. When compared to baseline, three (60%) patients had a >10% reduction in heart rate, one (20%) patient had a >10% reduction in oxygen saturations, and one (20%) patient had a >30% decrease in blood pressure. Amongst all patients, no significant complications occurred and haemodynamic changes from baseline did not result in need for intervention or interruption of study.

Intranasal dexmedetomidine may be a reasonable option for echocardiography sedation in infants with shunt-dependent single ventricle heart disease, and further investigation is warranted to ensure efficacy and safety in an outpatient setting.

我们研究了鼻内右美托咪定用于经胸超声心动图镇静的单心室生理学和高危间期分流依赖型肺血流患者的疗效和并发症情况。

一项单中心回顾性审查确定了接受右美托咪定进行超声心动图镇静的阶段间婴儿。报告基线和程序生命体征。与镇静相关的显着不良事件被定义为护理升级或需要任何额外/增加的正性肌力支持以维持术前血流动力学。轻微不良事件定义为基线血流动力学的变化，无需干预即可解决。为了评估镇静是否充分，对超声心动图报告的完整性进行了审查。

2020 年 9 月至 12 月，5 名间期患者（年龄 29-69 天）接受 3 mcg/kg 鼻内右美托咪定镇静。中位镇静起效时间和持续时间分别为 24 分钟（范围 12-43 分钟）和 60 分钟（范围 33-60 分钟）。镇静对于所有患者来说都是足够的，因为在没有救援剂量的情况下完成了完整的超声心动图检查。与基线相比，三名 (60%) 患者心率下降 >10%，一名 (20%) 患者血氧饱和度下降 >10%，一名 (20%) 患者血氧饱和度下降 >30%在血压方面。在所有患者中，没有发生明显的并发症，并且相对于基线的血流动力学变化不会导致需要干预或中断研究。

鼻内右美托咪定可能是分流依赖性单心室心脏病婴儿超声心动图镇静的合理选择，需要进一步研究以确保门诊环境中的有效性和安全性。