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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02780427
Other study ID # Wzhang03
Secondary ID
Status Completed
Phase Phase 4
First received
Last updated
Start date August 10, 2019
Est. completion date May 20, 2022

Study information

Verified date October 2022
Source Guangzhou Women and Children's Medical Center
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The median effective dose (ED50) and ED95 of intranasal dexmedetomidine as a single bolus have not been described for sedation in children undergoing transthoracic echocardiography (TEE) study. This information is important to compare agents and to determine the most effective sedative dose. The investigators performed a two-stage study to determine the ED50 and the ED95 of intranasal dexmedetomidine to investigate age-related differences in participants undergoing transthoracic echocardiography study.


Description:

The investigators performed a two-stage study to determine the ED50 and the ED95 of intranasal dexmedetomidine in children undergoing transthoracic echocardiography study. In phase 1, 120 participants were randomized in a Dixon-Massey study to describe the minimum local sedative dose. In phase 2, a further 160 participants were randomly allocated to receive sedation with doses in the upper dose-response range to define the ED95


Recruitment information / eligibility

Status Completed
Enrollment 320
Est. completion date May 20, 2022
Est. primary completion date January 1, 2021
Accepts healthy volunteers No
Gender All
Age group 1 Month to 24 Months
Eligibility Inclusion Criteria: - Children, aged between one and 24 months. classified as (American Society of Anesthesiologists) ASA physical status I or II, undergoing TEE were enrolled in the study. Exclusion Criteria: - Known allergy or hypersensitive reaction to dexmedetomidine - Organ dysfunction, and significant developmental delays or behavior problems - Cardiac arrhythmia - Known. acyanotic congenital heart disease or children after cardiac interventional procedures for follow-up examination.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
intranasal dexmedetomidine
Phase 1, Children received a bolus of intranasal dexmedetomidine which adjusted by the "Dixon up-and-down method for TEE study. The first child received 2.5 mcg/kg of intranasal dexmedetomidine dose (100mcg/ml), and the dose varied by 0.1 mcg/kg according to the up-and-down method Phase 2 was a dose-escalation study. After interim analysis of the phase 1 results, four dose levels above the calculated ED50 were defined. Dose spacing was set at 0.25 mcg/kg of intranasal dexmedetomidine consistent with the re-estimated standard deviation (SD).

Locations

Country Name City State
China Department of Anesthesiology of Guangzhou Women and Children's Medical Center Guangzhou Guangdong

Sponsors (1)

Lead Sponsor Collaborator
Guangzhou Women and Children's Medical Center

Country where clinical trial is conducted

China, 

Outcome

Type Measure Description Time frame Safety issue
Other heart rate Bradycardia was defined as a reduction in heart rate more than 20% from the baseline values up to 3 hours after drug administration
Other Oxyhemoglobin desaturation Significant Oxyhemoglobin desaturation was defined as < 90%. up to 3 hours after drug administration
Other non-invasive systolic blood pressure Hypotension was defined as a reduction in systolic blood pressure more than 20% from the baseline values up to 3 hours after drug administration
Primary The ED50 doses for intranasal dexmedetomidine Phase 1: The starting dose of dexmedetomidine was 2.5 mcg/kg. These doses varied by 0.1 mcg/kg, according to the up-and-down method 18. If the detected MOAA/S score was >3 within 45 minutes after intranasal administration, or clinically adequate diagnostic-quality images could not be acquired, sedation was considered a failure; and the dexmedetomidine dose was increased by 0.1 mcg/kg in the next patient of the same age group. In contrast, if the detected MOAA/S score was =3 and the acquisition of clinically adequate diagnostic-quality images was possible, the sedation was considered successful; and the dexmedetomidine dose was decreased by 0.1 mcg/kg in the next patient o up to 0.5 hours after transthoracic echocardiography
Primary The ED95 doses for intranasal dexmedetomidine Phase 2 was a dose-escalation study. After interim analysis of the phase 1 results, four dose levels above the calculated ED50 were defined. Dose spacing was set at 0.3 mcg/kg of intranasal dexmedetomidine consistent with the re-estimated standard deviation (SD). Defined levels were set at about 2.5, 2.75, 3.0, and 3.25 mcg/kg of intranasal dexmedetomidine. Criteria for success and failure were identical to those in phase 1.
Successful sedation was defined as a MOAA/S score between 0-3 and allowed the acquisition of clinically adequate diagnostic-quality images, while failure was defined as a MOAA/S score >3 within 45 minutes or clinically adequate diagnostic-quality images could not be acquired
up to 0.5 hours after transthoracic echocardiography
Primary Score of physical movement Movement score was recorded by sonographers who were blinded to the sedative regimen.
No movement
Occasional, slight movement
Frequent, slight movement
Vigorous movement limited to extremities
Vigorous movement, including torso and head
up to 0.5 hours after transthoracic echocardiography
Secondary sedation induction time Successful sedation was defined as an MOAA/S of between 0 and 3, and sedation induction time was defined as the time from drug administration to the onset of satisfactory sedation up to 2 hours after drug administration
Secondary Wake -up time Children were classified as awake if the MOAA/S was between 4 and 6. Wake -up time was defined as the time from successful sedation until the time that the child awoke up to 2 hours after drug administration