Evidence map›Paper›PMID 33119787›Full record

ArticleEuropean journal of clinical pharmacology2021

Off-label use of dexmedetomidine in paediatric anaesthesiology: an international survey of 791 (paediatric) anaesthesiologists.

Camille E van Hoorn, Robert B Flint, Justin Skowno, Paul Davies, Thomas Engelhardt, Kirk Lalwani, Olutoyin Olutoye, Erwin Ista, Jurgen C de Graaff

Registry-linked trialOpen access · hybridAbstract read
In one paragraph

Article in European journal of clinical pharmacology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05192629 (Prospective, Randomized, Double-blind, Double-dummy, Active-controlled, Phase 3 Clinical Trial Comparing the Safety and Efficacy of Intranasal Dexmedetomidine to Oral Midazolam as Premedication for Propofol Sedation in Pediatric Patients Undergoing Magnetic Resonance Imaging), which is not on this map. Cited by 16 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 3 pooled it
4.5field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05192629 phase3unknown statusnot on this mapstarted 2022, after this paper: background citation

Prospective, Randomized, Double-blind, Double-dummy, Active-controlled, Phase 3 Clinical Trial Comparing the Safety and Efficacy of Intranasal Dexmedetomidine to Oral Midazolam as Premedication for Propofol Sedation in Pediatric Patients Undergoing Magnetic Resonance Imaging

TypeinterventionalSponsorBrugmann University HospitalRan2022 to 2023Enrolled250ConditionsMRI, Pediatric Sedation, Midazolam, DexmedetomidineArmsDexmedetomidine, Midazolam
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.

  1. Guideline
  2. Pooled it
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  7. Clinical observation of dexmedetomidine nasal spray in the treatment of sleep disorders on the first night after undergoing maxillofacial surgery: a single-center double-blind randomized controlled study.Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques · 2023
    Trial
  8. Trial
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  11. Review
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  14. Safety of Dexmedetomidine as an Alternative Pediatric Magnetic Resonance Imaging (MRI) Sedative: A Retrospective Single-Center Study.Medical science monitor : international medical journal of experimental and clinical research · 2022
    Article
  15. Article
  16. Delayed Sequence Intubation in Children, Why Not?Saudi journal of medicine & medical sciences
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 5 countries.

Camille E van HoornDepartment of Anaesthesiology, Erasmus University Medical Centre -Sophia Children's Hospital, Rotterdam, The Netherlands. c.vanhoorn@erasmusmc.nl.ORCID https://orcid.org/0000-0002-8222-1848
Robert B FlintDivision of Neonatology, Department of Paediatrics, Erasmus University Medical Centre -Sophia Children's Hospital, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0002-3658-594X
Justin SkownoDepartment of Anaesthesiology, Children's Hospital at Westmead, University of Sydney, Sydney, Australia.ORCID https://orcid.org/0000-0002-4398-2150
Paul DaviesDepartment of Anaesthesia and Pain Management, The Royal Children's Hospital, Melbourne, Australia.
Thomas EngelhardtDepartment of Anaesthesia, Royal Children's Hospital Aberdeen and School of Medicine, University of Aberdeen, Aberdeen, UK.
Kirk LalwaniDepartment of Anaesthesiology and Paediatrics, Oregon Health and Science University, Portland, OR, USA.
Olutoyin OlutoyeDepartment of Anaesthesiology, Peri-operative and Pain Medicine, Texas Children's Hospital, Houston, TX, 77030, USA.
Erwin IstaDepartment of Internal Medicine - Nursing Science, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Jurgen C de GraaffDepartment of Anaesthesiology, Erasmus University Medical Centre -Sophia Children's Hospital, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0002-2168-7900
Erasmus MC - Sophia Children’s Hospital · NLErasmus MC · NLOregon Health & Science University · USRoyal Children's Hospital · AUTexas Children's Hospital · USThe University of Sydney · AUUniversity of Aberdeen · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this international study was to investigate prescribing practices of dexmedetomidine by paediatric anaesthesiologists.

methodsWe performed an online survey on the prescription rate of dexmedetomidine, route of administration and dosage, adverse drug reactions, education on the drug and overall experience. Members of specialist paediatric anaesthesia societies of Europe (ESPA), New Zealand and Australia (SPANZA), Great Britain and Ireland (APAGBI) and the USA (SPA) were consulted. Responses were collected in July and August 2019.

resultsData from 791 responders (17% of 5171 invitees) were included in the analyses. Dexmedetomidine was prescribed by 70% of the respondents (ESPA 53%; SPANZA 69%; APAGBI 34% and SPA 96%), mostly for procedural sedation (68%), premedication (46%) and/or ICU sedation (46%). Seventy-three percent had access to local or national protocols, although lack of education was the main reason cited by 26% of the respondents not to prescribe dexmedetomidine. The main difference in dexmedetomidine use concerned the age of patients (SPA primarily < 1 year, others primarily > 1 year). The dosage varied widely ranging from 0.2-5 μg kg

conclusionThe majority of anaesthesiologists use dexmedetomidine in paediatrics for premedication, procedural sedation, ICU sedation and anaesthesia, despite the off-label use and sparse evidence. The large intercontinental differences in prescribing dexmedetomidine call for consensus and worldwide education on the optimal use in paediatric practice.

Indexed as

AnesthesiologistsAnesthesiologyChildDexmedetomidineHumansHypnotics and SedativesOff-Label UsePediatricsSurveys and QuestionnairesDexmedetomidineHypnotics and SedativesAnaesthesiaDexmedetomidineDrug prescriptionsOff-label usePaediatricsPharmacology

Identifiers

PMID33119787
PMCPMC7935836
OpenAlexW3095778807

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.