Dexmedetomidine versus midazolam sedation for autistic children undergoing electroencephalogram: a prospective randomized trial

Abstract

Abstract Background Dexmedetomidine procedural sedation for pediatric patients undergoing radiological imaging has proved to be effective and safe. Objective We compared the efficacy of outpatient sedation with intravenous dexmedetomidine versus intravenous midazolam in autistic children undergoing electroencephalogram. Patients and methods Forty pediatric autistic patients aged 6–11 years old undergoing electroencephalogram were studied. In the dexmedetomidine group, patients received a loading dose of IV dexmedetomidine 1 μg/kg slowly over 10 min followed by an IV infusion of dexmedetomidine 0.7 μg/kg/h stopped when Ramsay sedation score (RSS) reached 4. In the midazolam group (n = 20), patients received induction with a loading dose of 0.05 mg/kg midazolam given over 2 min, then wait another 2 to 5 min to evaluate the sedative effect. Additional doses of IV midazolam (0.05 mg/kg) were given until we reached RSS reached 4. Sedation score, induction time, recovery time, behavioral scores, parents’ satisfaction scores, success rate, oxygen saturation, and the incidence of complications as bradycardia and attacks of agitation were recorded. Results Dexmedetomidine was associated with shorter induction and recovery times(< 0.001) and higher percentage of oxygen saturation compared with midazolam group (P < 0.001). The dexmedetomidine group showed higher sedation and behavioral scores as well as success rate compared with midazolam. Parents’ satisfaction scores were significantly higher in the dexmedetomidine group. The incidence of agitation was significantly higher in the midazolam group compared with the dexmedetomidine group (p = 0.035). Conclusion Dexmedetomidine is a feasible sedation technique in autistic children undergoing outpatient electroencephalogram in terms of faster recovery and less incidence of complications.