Efficacy and Safety of Intranasal Dexmedetomidine Combined With Oral Chloral Hydrate for Sedation in Neonatal MRI Procedures: A Single-Center Retrospective Study

Abstract

Background: Pharmacological sedation during neonatal magnetic resonance imaging (MRI) is crucial for procedure success and minimizing artifacts. Hence, it is vital to evaluate the effectiveness and safety of conventional sedatives in this population. In this study, we aim to evaluate the effectiveness of oral chloral hydrate combined with intranasal dexmedetomidine in neonatal MRI.

Methods: Neonates aged 0 to 28 days undergoing MRI were enrolled and received intranasal dexmedetomidine followed by oral chloral hydrate. Subsequently, sedation scores, onset time, and overall time of sedation, as well as any potential adverse reactions, were recorded.

Results: All neonates completed the MRI without notable adverse reactions. 128 neonates (90.1%) completed the MRI study with a single dose, while 14 neonates (9.9%) required additional medications. In the neonates with a single dose, no statistically significant differences in onset time were observed across postnatal days, gender, and weight. And no statistically significant differences in total time were observed across postnatal days and gender. However, the total time was significantly extended in the neonates with a weight under 3 kg. Furthermore, compared to the neonates with a single dose, the total time was significantly extended in the neonates with additional medications.

Conclusion: Oral chloral hydrate combined with intranasal dexmedetomidine is effective and safe for neonatal MRI, but extra attention is needed for neonates under 3 kg.