Dexmedetomidine's effect on neonatal sedation, pain, respiratory status and cardiovascular system.

OBJECTIVE

To describe the effects of dexmedetomidine on sedation, pain, respiratory status, and hemodynamics in neonates.

METHODS

A retrospective study of 206 infants in a level IV NICU (2016-2021) receiving continuous dexmedetomidine infusion. Pain/sedation scores, BP, vasopressor and inotrope score (VIS), and concomitant sedatives/analgesics (CSA) were recorded before and every 3-4 h for 24 h.

RESULTS

Median PMA:32 weeks. Hypotension occurred in 26%, primarily in infants <32weeks PMA, correlating with higher VIS and CSA. CSA use significantly predicted vasopressors/inotrope use.

CONCLUSION

Dexmedetomidine, with CSA, increases cardiovascular instability in preterm infants who have unique myocardial structure and function and therefore higher vulnerability.

CLINICAL TRIAL REGISTRATION (IF ANY): None (not applicable).