Esketamine Combined With Dexmedetomidine Sedation in Head MRI Examination of Children With Autism Spectrum Disorder

Maternal and Child Health Hospital of Hubei Province

Status and phase: Completed; Phase 2

Conditions: Esketamine; Autism Spectrum Disorder; Dexmedetomidine; Sedation

Treatments: Other: dexmedetomidine and esketamine; Other: low dos dexmedetomidine; Other: high dos dexmedetomidine

Study type: Interventional

Funder types: Other

Identifiers

NCT06633315

MCHH_05

Details and patient eligibility

About

Objective: To investigate the use of ketamine combined with dexmedetomidine for sedation in children with autism spectrum disorder, Methods:aged 2-6 years,, ASA grade I or II. The children were randomly divided into three groups using a random number table method: a low-dose dexmedetomidine group (DEXL group,n=100）The high-dose group of dexmedetomidine (DEXH group,n=100) and the group of esketamine combined with dexmedetomidine (DEXE group,n=100). The DEXL group received 2.5 μ g/kg of dexmedetomidine nasal drops, the DEXH group received 3 μ g/kg of dexmedetomidine nasal drops, and the DEXE group received 2 μ g/kg of dexmedetomidine nasal drops plus 0.5 mg/kg of ketamine nasal drops. Record the success rate of the first dose of nasal sedation, the onset time of sedation, the time of sedation recovery, the quality of recovery, and the satisfaction of the examining physician. Record the vital signs of three groups of patients during the examination process, including before sedation (T0), after successful sedation (T1), after the end of the examination (T2), and upon awakening (T3).

Full description

Autism Spectrum Disorder (ASD), also known as Autism Spectrum Disorder (ASD), is a condition in which approximately 60% to 70% of autistic children have intellectual disabilities that significantly affect their ability to take care of themselves and bring immense pressure to society and families. Autistic children often have neurological disorders, and therefore require head magnetic resonance imaging (MRI) examinations. MRI examinations can detect abnormal changes in brain structure and function, providing more objective evidence for early diagnosis and valuable treatment time for autistic patients. However, MRI examinations require children to maintain a calm and quiet state, minimizing physical activity as much as possible. Due to the specific interests and behaviors of autistic children, as well as their refusal to accept environmental changes, completing MRI examinations often requires sedation or anesthesia. The main drugs currently used for sedation in pediatric outpatient examinations include dexmedetomidine, midazolam, ketamine, etc. This study aims to select children with ASD who are scheduled to undergo head MRI in outpatient settings, and explore the safety and efficacy of intranasal administration of ketamine combined with dexmedetomidine for sedation, providing reference methods and evidence for sedation in children with autism spectrum disorder.

Enrollment: 300 patients

Sex: All

Ages: 2 to 4 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Clinical diagnosis of autism spectrum disorder Aged 2-6 years, ASA grade I or II

Exclusion criteria

Upper respiratory tract infections, Severe respiratory system related diseases Congenital heart disease Liver and kidney dysfunction. Contraindications for ketamine and dexmedetomidine, Expected difficult airways. Anesthetic or sedative drugs used in the last week.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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300 participants in 3 patient groups

High dose dexmedetomidine

Experimental group

Description:

received high dose dexmedetomidine,received dexmedetomidine 3 μ g/kg nasal drops,Record the success rate of the first dose of nasal sedation, the onset time of sedation, the time of sedation recovery, the quality of recovery, and the satisfaction of the examining physician. Record the vital signs of three groups of patients during the examination process, including before sedation (T0), after successful sedation (T1), after the end of the examination (T2), and upon awakening (T3). Compare the incidence of adverse reactions during sedation, including bradycardia, nausea and vomiting, nystagmus, postoperative agitation, and delayed awakening, among the three groups of patients.

Treatment:

Other: high dos dexmedetomidine

Dexmedetomidine and esketamine

Experimental group

Description:

received dexmedetomidine plus esketamine ,received dexmedetomidine 2 μ g/kg nasal drops plus esketamine 0.5 mg/kg nasal drops.Record the success rate of the first dose of nasal sedation, the onset time of sedation, the time of sedation recovery, the quality of recovery, and the satisfaction of the examining physician. Record the vital signs of three groups of patients during the examination process, including before sedation (T0), after successful sedation (T1), after the end of the examination (T2), and upon awakening (T3). Compare the incidence of adverse reactions during sedation, including bradycardia, nausea and vomiting, nystagmus, postoperative agitation, and delayed awakening, among the three groups of patients.

Treatment:

Other: dexmedetomidine and esketamine

Low dos dexmedetomidine

Experimental group

Description:

received dexmedetomidine 2.5 μ g/kg nasal drops, Record the success rate of the first dose of nasal sedation, the onset time of sedation, the time of sedation recovery, the quality of recovery, and the satisfaction of the examining physician. Record the vital signs of three groups of patients during the examination process, including before sedation (T0), after successful sedation (T1), after the end of the examination (T2), and upon awakening (T3). Compare the incidence of adverse reactions during sedation, including bradycardia, nausea and vomiting, nystagmus, postoperative agitation, and delayed awakening, among the three groups of patients.

Treatment:

Other: low dos dexmedetomidine