- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03806777
Intra-nasal Dexmedetomidine for Children Undergoing MRI Imaging (DexmedMRI)
Study Overview
Detailed Description
Purpose:
To assess the use of IN-dex as a sole agent in aiding the successful completion of a MRI scan in children.
Hypothesis:
We hypothesize that the optimal dose for IN-dex to produce appropriate sedation for MRI will be between 1 and 3 mcg/kg. We also hypothesize that this dose will be lower in the older age group.
Justification:
The dose required for IN-dex to enable safe sedation for MRI scanning as a sole agent is undetermined at present. This study will enable us to find the optimal dose for effective sedation for MRI scanning in a range of age groups. This will avoid the need for propofol and remifentanil general anesthesia (that is the current standard of care) in this group of patients. Our motivation for avoiding general anesthesia is that there is ongoing concern that general anesthesia causes long term neurocognitive effects in children. Finally, identifying a safe yet effective dose of IN-dex, which can be nurse-administered, will also allow us to improve access to MRI scans that are limited by the access to general anesthesia.
Objectives:
- To determine the dose of IN-dex that, when used as a sole agent, produces minimal to moderate sedation that is adequate for successful completion of MRI in children with >90% effectiveness.
- To explore the logistics of a nurse-administered sedation protocol to increase access to the MRI.
Research Design:
We propose a dose finding study of IN-dex using the biased coin design (BCD) method in three different age groups (3 to <8 years, 8 to <12 years, 12 to <19 years). The study specific interventions will include identification of children appropriate for the study following detailed assessment using a scoring system developed by our Child Life specialists for use at their MRI preparation session.
Statistical Analysis:
The dose of IN-Dex that produces mild to moderate sedation in 90% of subjects will be calculated using the pooled adjacent violators algorithm (PAVA) and bootstrap methods will be used to calculate the 95% confidence limits.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Andrew K Poznikoff, BSc
- Phone Number: 1989 604-875-2000
- Email: andrew.poznikoff@cw.bc.ca
Study Contact Backup
- Name: Mark Ansermino, FRCA
- Phone Number: 604-875-2711
- Email: mansermino@cw.bc.ca
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- ASA 1 or 2
- Scheduled for elective MRI scan on the general anesthesia list
- Child Life MRI simulation score of 6-10 (Figure 1)
- Age 3 - 18
Exclusion Criteria:
- Taking existing opioid, sedative, or cannabinoid medication
- Severe learning disability defined as the inability to follow simple commands
- Severe Cardiac disease
- Chronic hypertension
- Allergy to dexmedetomidine
- Nasal anatomical abnormality
- Known or anticipated difficult airway
Study Plan
How is the study designed?
Design Details
- Primary Purpose: HEALTH_SERVICES_RESEARCH
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Intra-nasal dexmedetomidine
A single dose of dexmedetomidine, determined by a biased coin algorithm (min: 1 mcg/kg; max: 4 mcg/kg or 200mcg), will be delivered intranasally 45min before an MRI scan.
|
Highly selective alpha-2 adrenergic agonist with sedative properties.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Dose
Time Frame: Immediately after completion of the MRI scan.
|
The intranasal dexmedetomidine dose in mcg/kg that produces successful completion of MRI scan with acceptable MRI image quality in 90% of individuals (ED 90).
|
Immediately after completion of the MRI scan.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Uninterrupted scans
Time Frame: Immediately after completion of the MRI scan.
|
Total number of scans that were able to be completed without interruptions
|
Immediately after completion of the MRI scan.
|
Respirator support
Time Frame: During MRI scan
|
Total number of occurrences of respiratory support
|
During MRI scan
|
Adverse events
Time Frame: During MRI scan
|
Occurrence of haemodynamic disturbance (bradycardia: absolute heart rate ≤ 40 bpm, hypertension: relative mean arterial pressure ≥ 50% baseline, hypotension: relative mean arterial pressure ≤ 50% baseline)
|
During MRI scan
|
modified Yale Preoperative Anxiety Scale (mYPAS)
Time Frame: Immediately before administration of intranasal dexmedetomidine
|
Pre-procedure mYPAS score.
The scale is a total summed score (4-22) of 5 areas; Activity (1-4), Vocalizations (1-6), Emotional expressivity (1-4), state of apparent arousal (1-4), and use of parents (1-4).
A lower score represents a lower level of anxiety.
|
Immediately before administration of intranasal dexmedetomidine
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Mark Ansermino, FRCA, BC Children's Hospital, Department of Anesthesia
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (ANTICIPATED)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Analgesics, Non-Narcotic
- Adrenergic alpha-2 Receptor Agonists
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Hypnotics and Sedatives
- Dexmedetomidine
Other Study ID Numbers
- H18-02794
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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