Pediatric cardiac catheterization procedure with dexmedetomidine sedation: Radiographic airway patency assessment.
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Date
2015-01
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Abstract
Aims: The aim of the study was to measure airway patency objectively during dexmedetomidine
sedation under radiographic guidance in spontaneously breathing pediatric patients scheduled for cardiac
catheterization procedures. Subjects and Methods: Thirty‑five patients in the age group 5–10 years
scheduled for cardiac catheterization procedures were enrolled. All study patients were given loading dose
of dexmedetomidine at 1 μg/kg/min for 10 min and then maintenance dose of 1.5 μg/kg/h. Radiographic
airway patency was assessed at the start of infusion (0 min) and after 30 min. Antero‑posterior (AP) diameters
were measured manually at the nasopharyngeal and retroglossal levels. Dynamic change in airway between
inspiration and expiration was considered a measure of airway collapsibility. Patients were monitored for
hemodynamics, recovery time and complications. Statistical Analysis: Student paired t‑test was used for
data analysis. P < 0.05 was considered significant. Results: Minimum and maximum AP diameters were
compared at 0 and 30 min. Nasopharyngeal level showed significant reduction in the minimum (6.27 ± 1.09 vs.
4.26 ± 1.03, P < 0.0001) and maximum (6.51 ± 1.14 vs. 5.99 ± 1.03, P < 0.0001) diameters. Similarly
retroglossal level showed significant reduction in the minimum (6.98 ± 1.09 vs. 5.27 ± 1.15, P < 0.0001)
and maximum (7.49 ± 1.22 vs. 6.92 ± 1.12, P < 0.0003) diameters. The degree of collapsibility was greater
at 30 min than baseline (P < 0.0001). There was a significant decrease in heart rate (P < 0.0001), and the
average recovery time was 39.86 ± 12.22 min. Conclusion: Even though airway patency was maintained in
all children sedated with dexmedetomidine, there were significant reductions in the upper airway dimensions
measured, so all precautions to manage the airway failure should be taken.
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Keywords
Airway, dexmedetomidine, radiographic assessment
Citation
Thimmarayappa Ashwini, Chandrasekaran Nivash, Jagadeesh A M, Joshi Shreedhar S. Pediatric cardiac catheterization procedure with dexmedetomidine sedation: Radiographic airway patency assessment. Annals of Cardiac Anaesthesia. 2015 Jan-Mar ; 18(1): 29-33.