{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:24:11Z","timestamp":1777469051542,"version":"3.51.4"},"reference-count":26,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,8,28]],"date-time":"2022-08-28T00:00:00Z","timestamp":1661644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>There is an increasing need for effective anxiety and pain reduction during medical imaging procedures in children, addressed by non-pharmacological or pharmacological approaches. Dexmedetomidine is a fairly recently marketed, selective \u03b12-adrenergic agonist that can be administered intranasally. To develop an evidence-guided clinical protocol, we investigated the (side) effects, preconditions and safety aspects following intranasal dexmedetomidine administration in children (1 month\u20135 years) for procedural sedation during medical imaging. To this end, a systematic search (PubMed, Embase and CINAHL (12\/2021)) was performed to identify studies on intranasal dexmedetomidine for procedural sedation for medical imaging (computer tomography and magnetic resonance imaging). Following screening and quality assessment, eight studies were retained. Nasal nebulization was considered the best administration method, dosing varied between 2 and 4 \u00b5g\/kg (age-dependent) 30\u201345 min prior to imaging and contraindications or restrictions with respect to oral intake were somewhat consistent across studies. Valid sedation scores and monitoring of vital signs were routinely used to assess sedation and the need for rescue dosing (different approaches), whereas discharge was generally based on Aldrete score (score \u2265 9). Heart rate, blood pressure and saturation were routinely monitored, with commonly observed bradycardia or hypotension (decrease by 20%). Based on these findings, a roadmap for evidence-guided clinical protocol was generated.<\/jats:p>","DOI":"10.3390\/children9091310","type":"journal-article","created":{"date-parts":[[2022,8,28]],"date-time":"2022-08-28T21:22:56Z","timestamp":1661721776000},"page":"1310","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Intranasal Dexmedetomidine as Sedative for Medical Imaging in Young Children: A Systematic Review to Provide a Roadmap for an Evidence-Guided Clinical Protocol"],"prefix":"10.3390","volume":"9","author":[{"given":"Kato","family":"Hermans","sequence":"first","affiliation":[{"name":"Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Levuen, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2792-9584","authenticated-orcid":false,"given":"Larissa","family":"Ramaekers","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Levuen, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9339-5408","authenticated-orcid":false,"given":"Jaan","family":"Toelen","sequence":"additional","affiliation":[{"name":"Child and Youth Institute, KU Leuven, Herestraat 49, 3000 Leuven, Belgium"},{"name":"Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium"},{"name":"Department of Pediatrics, University Hospitals UZ Leuven, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9070-6610","authenticated-orcid":false,"given":"Koen","family":"Vanhonsebrouck","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospitals UZ Leuven, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9921-5105","authenticated-orcid":false,"given":"Karel","family":"Allegaert","sequence":"additional","affiliation":[{"name":"Child and Youth Institute, KU Leuven, Herestraat 49, 3000 Leuven, Belgium"},{"name":"Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium"},{"name":"Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium"},{"name":"Department of Hospital Pharmacy, Erasmus MC, 3000 GA Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,28]]},"reference":[{"key":"ref_1","unstructured":"United Nations (2022, August 11). United Nations Human Rights. Available online: https:\/\/www.ohchr.org\/en\/instruments-mechanisms\/instruments\/convention-rights-child."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S0140-6736(06)68230-5","article-title":"Procedural sedation and analgesia in children","volume":"367","author":"Krauss","year":"2006","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e20191000","DOI":"10.1542\/peds.2019-1000","article-title":"Guidelines for Monitoring and Management of Pediatric Patients before, during, and after Sedation for Diagnostic and Therapeutic Procedures","volume":"143","author":"Wilson","year":"2019","journal-title":"Pediatrics"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Kerkhofs, L., Allegaert, K., Toelen, J., and Vanhonsebrouck, K. (2022). Pediatric Procedural Sedation and Analgesia (PROSA) in the Leuven university Hospitals: An audit on efficacy and safety. 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[3rd ed.].","DOI":"10.1007\/978-3-030-58406-1"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/9\/1310\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:19:15Z","timestamp":1760141955000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/9\/1310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,28]]},"references-count":26,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["children9091310"],"URL":"https:\/\/doi.org\/10.3390\/children9091310","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints202208.0312.v1","asserted-by":"object"}]},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,28]]}}}