[Pediatric_sedation] intranasal dexmedetomidine and mucosal atomization device

[joycephil@aol.com]

We have used intranasal dex as both a premed and as a sole sedative for 
CT.
We administer it using the M.A.D. (mucosal atomization device) also 
known as the "marshmallow" which is distributed by Wolfe Tory. It 
produces a fine mist with maximal mucosal coverage. We have used doses 
from 2-5 mcg/kg of precedex intranasally as a premed particularly in 
children with autism.  The precedex is odorless and painless and the 
administration is quick. Onset is in 20 minutes with maximal effect in 
about 40 minutes. Children are generally sleepy for about an hour and a 
half. We have seen no hemodynamic changes using these doses
and this route of administration.  I have on occasion given a second 
nasal dose without problem.

Joyce Phillips, MD, FAAP
University of New Mexico
Department of Anesthesiology