Re: [Pediatric_sedation] intranasal dexmedetomidine andmucosalatomization device

["Lubisch, Nina" <Nlubisch@browardhealth.org>]

Minimal to moderate dependent on dose and child. When moderate every 5
minutes when minimal evry 15 min. But when minimal it is usually for a
very quick procedure.
Nina

-----Original Message-----
From: pediatric_sedation-bounces+nlubisch=nbhd.org@listserve.com
[mailto:pediatric_sedation-bounces+nlubisch=nbhd.org@listserve.com] On
Behalf Of Van der Jagt, Elise
Sent: Tuesday, June 23, 2009 4:47 PM
To: Pediatric Sedation Discussion
Subject: Re: [Pediatric_sedation] intranasal dexmedetomidine
andmucosalatomization device

Joyce, 

Does this dose generally lead to a minimal, moderate or deep sedation
level? And how do you monitor them? Thanks.  

Elise 

Elise W. van der Jagt, MD, MPH
Professor of Pediatrics/Critical Care
Golisano Children's Hospital
University of Rochester Medical Center
601 Elmwood Ave., Box 667
Rochester, NY, 14642
Tele:  (585) 275-8138
Fax:  (585) 275-0707
E-mail:  elise_van_der_jagt@urmc.rochester.edu
 

-----Original Message-----
From: pediatric_sedation-bounces@listserve.com
[mailto:pediatric_sedation-bounces@listserve.com] On Behalf Of
joycephil@aol.com
Sent: Monday, June 22, 2009 4:41 PM
To: pediatric_sedation@listserve.com
Subject: [Pediatric_sedation] intranasal dexmedetomidine and
mucosalatomization device

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
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