{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T22:01:19Z","timestamp":1768514479903,"version":"3.49.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003483","name":"Hebrew University of Jerusalem","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003483","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Dexmedetomidine is an \u03b12-adrenergic receptor agonist known for its sedative and analgesic properties. It produces an EEG pattern resembling Stage II sleep without interfering with EEG interpretation, making it a preferred agent for pediatric sedation, particularly during EEG procedures. Traditionally administered as a bolus followed by continuous infusion, this approach can challenge workflow efficiency and staffing in resource-limited settings. This study aimed to evaluate the safety and efficacy of a rapid bolus-only dexmedetomidine protocol for pediatric EEG sedation. This retrospective study included pediatric patients aged 1\u201318\u00a0years undergoing EEG with sedation at the Hadassah Medical Center between 2015 and 2023. All patients received dexmedetomidine via intravenous bolus (1\u20132 mcg\/kg), with additional doses (0.5\u20132 mcg\/kg) as needed. No continuous infusion was used. Primary outcomes were sedation success rate, time to onset and recovery, and adverse events. A total of 345 patients were included. Sedation was successfully achieved in 99% of cases, with a median sedation onset of 5\u00a0min. The overall adverse event rate was 8.4%, with no sentinel events. Hypotension and hypoxia occurred in 1.7% of patients each. Patients with upper airway abnormalities were more likely to require additional doses (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.001) and showed a trend toward increased adverse events (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.095). Adverse event risk increased with higher total dexmedetomidine doses (\u2265\u20093 mcg\/kg,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.001).\u00a0\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion<\/jats:italic>\n                    : Rapid bolus administration of dexmedetomidine without continuous infusion provides effective sedation for pediatric EEG, with a good safety profile, similar to other sedation protocols. This cost-effective approach offers significant advantages for settings with limited staffing or high patient turnover.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td align=\"left\">\n                              <jats:bold>What is Known:<\/jats:bold>\n                              \u2022\n                              <jats:italic>Dexmedetomidine is well known as an effective agent for EEG procedural sedation<\/jats:italic>\n                              .\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td align=\"left\">\n                              <jats:bold>What is New:<\/jats:bold>\n                              \u2022\u00a0\n                              <jats:italic>We present a novel IV single bolus protocol utilizing dexmedetomidine that demonstrates a high success rate in\u00a0achieving adequate sedation, is associated with a low incidence of adverse events, and requires an overall lower dosage compared\u00a0<\/jats:italic>\n                              <jats:italic>to traditional methods<\/jats:italic>\n                              .\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-025-06567-x","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:37:10Z","timestamp":1763462230000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the safety and efficacy of rapid bolus-only dexmedetomidine for pediatric EEG sedation: a retrospective study"],"prefix":"10.1007","volume":"184","author":[{"given":"Yael","family":"Biro","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaacov","family":"Tabi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Gileles-Hillel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Rekhtman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"6567_CR1","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.yebeh.2008.01.013","volume":"13","author":"KJ Slifer","year":"2008","unstructured":"Slifer KJ, Avis KT, Frutchey RA (2008) Behavioral intervention to increase compliance with electroencephalographic procedures in children with developmental disabilities. Epilepsy Behav 13:189\u2013195. https:\/\/doi.org\/10.1016\/j.yebeh.2008.01.013","journal-title":"Epilepsy Behav"},{"key":"6567_CR2","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1097\/00007611-199009000-00015","volume":"83","author":"PD Rumm","year":"1990","unstructured":"Rumm PD, Takao RT, Fox DJ, Atkinson SW (1990) Efficacy of sedation of children with chloral hydrate. South Med J 83:1040\u20131043. https:\/\/doi.org\/10.1097\/00007611-199009000-00015","journal-title":"South Med J"},{"key":"6567_CR3","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/s0921-884x(96)96509-1","volume":"102","author":"M Thoresen","year":"1997","unstructured":"Thoresen M, Henriksen O, Wannag E, Laegreid L (1997) Does a sedative dose of chloral hydrate modify the EEG of children with epilepsy? Electroencephalogr Clin Neurophysiol 102:152\u2013157. https:\/\/doi.org\/10.1016\/s0921-884x(96)96509-1","journal-title":"Electroencephalogr Clin Neurophysiol"},{"key":"6567_CR4","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/s0022-3476(96)70256-1","volume":"129","author":"KL Napoli","year":"1996","unstructured":"Napoli KL, Ingall CG, Martin GR (1996) Safety and efficacy of chloral hydrate sedation in children undergoing echocardiography. J Pediatr 129:287\u2013291. https:\/\/doi.org\/10.1016\/s0022-3476(96)70256-1","journal-title":"J Pediatr"},{"key":"6567_CR5","doi-asserted-by":"publisher","first-page":"639","DOI":"10.2214\/ajr.161.3.8352124","volume":"161","author":"SB Greenberg","year":"1993","unstructured":"Greenberg SB, Faerber EN, Aspinall CL, Adams RC (1993) High-dose chloral hydrate sedation for children undergoing MR imaging: safety and efficacy in relation to age. AJR Am J Roentgenol 161:639\u2013641. https:\/\/doi.org\/10.2214\/ajr.161.3.8352124","journal-title":"AJR Am J Roentgenol"},{"key":"6567_CR6","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1097\/01.PCC.0000257100.31779.41","volume":"8","author":"JD Tobias","year":"2007","unstructured":"Tobias JD (2007) Dexmedetomidine: applications in pediatric critical care and pediatric anesthesiology. Pediatr Crit Care Med 8:115\u2013131. https:\/\/doi.org\/10.1097\/01.PCC.0000257100.31779.41","journal-title":"Pediatr Crit Care Med"},{"key":"6567_CR7","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1111\/j.1460-9592.2009.03160.x","volume":"19","author":"KP Mason","year":"2009","unstructured":"Mason KP, O\u2019Mahony E, Zurakowski D, Libenson MH (2009) Effects of dexmedetomidine sedation on the EEG in children. Paediatr Anaesth 19:1175\u20131183. https:\/\/doi.org\/10.1111\/j.1460-9592.2009.03160.x","journal-title":"Paediatr Anaesth"},{"key":"6567_CR8","doi-asserted-by":"publisher","first-page":"720","DOI":"10.2214\/AJR.10.6134","volume":"197","author":"KP Mason","year":"2011","unstructured":"Mason KP, Lubisch NB, Robinson F, Roskos R (2011) Intramuscular dexmedetomidine sedation for pediatric MRI and CT. AJR Am J Roentgenol 197:720\u2013725. https:\/\/doi.org\/10.2214\/AJR.10.6134","journal-title":"AJR Am J Roentgenol"},{"key":"6567_CR9","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1186\/s12871-020-00978-z","volume":"20","author":"H Chen","year":"2020","unstructured":"Chen H, Yang F, Ye M et al (2020) Intranasal dexmedetomidine is an effective sedative agent for electroencephalography in children. BMC Anesthesiol 20:61. https:\/\/doi.org\/10.1186\/s12871-020-00978-z","journal-title":"BMC Anesthesiol"},{"key":"6567_CR10","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1111\/pan.12851","volume":"26","author":"NM Baier","year":"2016","unstructured":"Baier NM, Mendez SS, Kimm D et al (2016) Intranasal dexmedetomidine: an effective sedative agent for electroencephalogram and auditory brain response testing. Paediatr Anaesth 26:280\u2013285. https:\/\/doi.org\/10.1111\/pan.12851","journal-title":"Paediatr Anaesth"},{"key":"6567_CR11","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1542\/hpeds.2022-007007","volume":"13","author":"DS Tsze","year":"2023","unstructured":"Tsze DS, Rogers AP, Baier NM et al (2023) Clinical outcomes associated with intranasal dexmedetomidine sedation in children. Hosp Pediatr 13:223\u2013243. https:\/\/doi.org\/10.1542\/hpeds.2022-007007","journal-title":"Hosp Pediatr"},{"key":"6567_CR12","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1111\/aas.13372","volume":"63","author":"H Liu","year":"2019","unstructured":"Liu H, Sun M, Zhang J et al (2019) Determination of the 90% effective dose of intranasal dexmedetomidine for sedation during electroencephalography in children. Acta Anaesthesiol Scand 63:847\u2013852. https:\/\/doi.org\/10.1111\/aas.13372","journal-title":"Acta Anaesthesiol Scand"},{"key":"6567_CR13","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1177\/1750458919854885","volume":"30","author":"J Lewis","year":"2020","unstructured":"Lewis J, Bailey CR (2020) Intranasal dexmedetomidine for sedation in children; a review. J Perioper Pract 30:170\u2013175. https:\/\/doi.org\/10.1177\/1750458919854885","journal-title":"J Perioper Pract"},{"key":"6567_CR14","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1016\/j.jpeds.2012.05.011","volume":"161","author":"KP Mason","year":"2012","unstructured":"Mason KP, Lubisch N, Robinson F et al (2012) Intramuscular dexmedetomidine: an effective route of sedation preserves background activity for pediatric electroencephalograms. J Pediatr 161:927\u2013932. https:\/\/doi.org\/10.1016\/j.jpeds.2012.05.011","journal-title":"J Pediatr"},{"key":"6567_CR15","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1111\/pan.12569","volume":"25","author":"JR Phelps","year":"2015","unstructured":"Phelps JR, Russell A, Lupa MC et al (2015) High-dose dexmedetomidine for noninvasive pediatric procedural sedation and discharge readiness. Paediatr Anaesth 25:877\u2013882. https:\/\/doi.org\/10.1111\/pan.12569","journal-title":"Paediatr Anaesth"},{"key":"6567_CR16","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1111\/j.1460-9592.2008.02468.x","volume":"18","author":"KP Mason","year":"2008","unstructured":"Mason KP, Zurakowski D, Zgleszewski SE et al (2008) High dose dexmedetomidine as the sole sedative for pediatric MRI. Paediatr Anaesth 18:403\u2013411. https:\/\/doi.org\/10.1111\/j.1460-9592.2008.02468.x","journal-title":"Paediatr Anaesth"},{"key":"6567_CR17","doi-asserted-by":"publisher","first-page":"529","DOI":"10.3389\/fphar.2017.00529","volume":"8","author":"EH Jooste","year":"2017","unstructured":"Jooste EH, Hammer GB, Reyes CR et al (2017) Phase IV, open-label, safety study evaluating the use of Dexmedetomidine in pediatric patients undergoing procedure-type sedation. Front Pharmacol 8:529. https:\/\/doi.org\/10.3389\/fphar.2017.00529","journal-title":"Front Pharmacol"},{"issue":"5","key":"6567_CR18","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1111\/pan.14857","volume":"34","author":"U Khan","year":"2024","unstructured":"Khan U, Hammer GB, Duncan-Azadi C et al (2024) A randomized, double-blind, dose-controlled study of the use of dexmedetomidine alone for procedural sedation of children and adolescents undergoing MRI scans. Paediatr Anaesth 34(5):405\u2013414. https:\/\/doi.org\/10.1111\/pan.14857","journal-title":"Paediatr Anaesth"},{"issue":"11","key":"6567_CR19","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1111\/pan.14290","volume":"31","author":"S Narayanasamy","year":"2021","unstructured":"Narayanasamy S, Winograd-Gomez V, Joshi H et al (2021) Outcomes of dexmedetomidine sedation for drug-induced sleep cin\u00e9 magnetic resonance imaging studies in pediatric obstructive sleep apnea patients. Paediatr Anaesth 31(11):1241\u20131249. https:\/\/doi.org\/10.1111\/pan.14290","journal-title":"Paediatr Anaesth"},{"key":"6567_CR20","doi-asserted-by":"publisher","first-page":"1517","DOI":"10.1016\/j.ijporl.2006.02.001","volume":"70","author":"A Francis","year":"2006","unstructured":"Francis A, Eltaki K, Bash T et al (2006) The safety of preoperative sedation in children with sleep-disordered breathing. Int J Pediatr Otorhinolaryngol 70:1517\u20131521. https:\/\/doi.org\/10.1016\/j.ijporl.2006.02.001","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"6567_CR21","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1213\/ane.0b013e3181a19e21","volume":"109","author":"DA Schwengel","year":"2009","unstructured":"Schwengel DA, Sterni LM, Tunkel DE, Heitmiller ES (2009) Perioperative management of children with obstructive sleep apnea. Anesth Analg 109:60\u201375. https:\/\/doi.org\/10.1213\/ane.0b013e3181a19e21","journal-title":"Anesth Analg"},{"key":"6567_CR22","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1097\/ACO.0000000000000187","volume":"28","author":"CJ Cot\u00e9","year":"2015","unstructured":"Cot\u00e9 CJ (2015) Anesthesiological considerations for children with obstructive sleep apnea. Curr Opin Anaesthesiol 28:327\u2013332. https:\/\/doi.org\/10.1097\/ACO.0000000000000187","journal-title":"Curr Opin Anaesthesiol"},{"key":"6567_CR23","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1111\/pan.12532","volume":"25","author":"JP Cravero","year":"2015","unstructured":"Cravero JP, Cot\u00e9 CJ (2015) Raising the bar for pediatric sedation studies and trials. Pediatr Anesth 25:2\u20134. https:\/\/doi.org\/10.1111\/pan.12532","journal-title":"Pediatr Anesth"}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-025-06567-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-025-06567-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-025-06567-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T06:43:09Z","timestamp":1768459389000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-025-06567-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,18]]},"references-count":23,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["6567"],"URL":"https:\/\/doi.org\/10.1007\/s00431-025-06567-x","relation":{},"ISSN":["1432-1076"],"issn-type":[{"value":"1432-1076","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,18]]},"assertion":[{"value":"5 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 November 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"772"}}