Dexmedetomidine for EEG sedation in children with behavioral disorders

OBJECTIVE

To evaluate the efficacy and safety of sedation with dexmedetomidine, a highly selective α2-agonist with sedative effect, for EEG recording in children with behavioral disorders.

MATERIAL AND METHODS

Prospective observational study on children with behavioral disorders undergoing EEG at the Pediatric Hospital in Padova, Italy. A 2 mcg/kg intravenous bolus of dexmedetomidine was administered, followed by a 1-2 mcg/kg/h infusion. If necessary, bolus was repeated up to 3 times to reach the target level of sedation, assessed by Pediatric Sedation State Scale. Patients were fully monitored before, during and after the procedure until complete recovery. EEG recording quality, and caregivers' satisfaction were collected. Any adverse effect was registered using SIVA score.

RESULTS

For this preliminary study, 19 patients were enrolled. EEG was successfully completed in all of them. Mean total dose of dexmedetomidine was 3.7 ± 1.7 mcg/kg. Adequate sedation was achieved within 11.9 ± 8 minutes. Mean time to first awakening was 30.9 ± 36.9 minutes and time to complete recovery 113.3 ± 92.7 minutes. Adverse effects (hypotension, bradycardia) were reported in 10 patients, all classified as "minor." EEG recording quality was good or excellent. Parents' satisfaction was high in all the interviewed families.

CONCLUSIONS

Intravenous dexmedetomidine as a single drug showed an excellent efficacy and good safety profile for EEG recording in children with behavioral disorders.

Medico-legal use of otoacoustic emissions in the audiological selection process for employment

A 6-year experience of the Italian Air Force Medical Selection Centre in the audiological evaluation of candidates for employment is summarized. Otoacoustic emissions (OAEs) were introduced progressively from 1993 to analyse more effectively subjects affected with sensorineural hearing loss and reduce possible bias connected to standard audiometric tests. OAEs provided a useful tool to support pure-tone audiometry, providing more accurate audiological data. Finally, a reduction of medico-legal claims was observed in candidates undergoing OAE testing.

Measurements in microscopic images: an inexpensive device for semi-automatic analysis of microscopic images

Measurement of histological and cytological parameters can be performed much faster and more accurate by means of a semi-automatic device that is described in detail. The system consists mainly of a medium-sized computer and one or more peripheral terminals. Each terminal incorporates a special measurement table for data acquisition, a keyboard for manual data input, and an interface. The software program for the evaluation and storage of the digital data is simple to write and offers a high degree of flexibility to the user. The system can be operated in real time.