Recent Advances in Dexmedetomidine for Paediatric Sedation
Keywords:
dexmedetomidine, paediatric sedation, intranasal, MRI, ICU, emergence delirium, hemodynamicsAbstract
Dexmedetomidine has transitioned from an off‑label adjunct to a central agent in paediatric sedation, especially for procedural, MRI, and intensive care indications,, –. Recent randomized trials, meta‑analyses, and pharmacologic reviews show that dexmedetomidine provides cooperative, arousable sedation with minimal respiratory depression, reduced emergence agitation, and improved perioperative behaviour compared with conventional sedatives, while bradycardia and hypotension remain the main dose‑related adverse effects,,,. High‑dose monotherapy regimens now achieve MRI completion without rescue propofol in a majority of children, and intranasal formulations broaden use in emergency and diagnostic settings by avoiding intravenous access,,. Ongoing systematic reviews of intranasal dexmedetomidine and evolving pharmacokinetic modelling aim to refine age‑specific dosing and clarify long‑term safety,. This article summarizes recent advances in routes, dosing, indications, and safety considerations that are reshaping dexmedetomidine‑based sedation in paediatric practice.
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