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August 20, 2026

Safety and Effectiveness of Intramuscular Dexmedetomidine Versus Per-Rectal Thiopental for Pediatric Brain Computed Tomography Sedation: A Retrospective Cohort Study.

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Authors

JSJisun ShinPusan National UniversitySRSeong Il RyuDKDahyun Kim

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Implication

Retrospective cohort study demonstrates comparable safety between intramuscular dexmedetomidine and per-rectal thiopental in children, indicating a viable cannulation-free sedation option.

Key Points

  • To evaluate the safety and effectiveness of transitioning from per-rectal thiopental to intramuscular dexmedetomidine for brain computed tomography sedation in children with traumatic head injuries.
  • Retrospective cohort study conducted at a tertiary pediatric emergency department in Korea comparing a per-rectal thiopental era (January 2024 to March 2025) with an intramuscular dexmedetomidine era (May 2025 to April 2026).
  • Analyzed 246 completed sedation episodes (137 per-rectal thiopental, 109 intramuscular dexmedetomidine) in alert children aged 1 month to 18 years undergoing brain CT for traumatic head injury.
  • Safe CT completion occurred in 97.1% of thiopental episodes versus 99.1% of dexmedetomidine episodes (risk difference +2.0 percentage points, 95% CI: -1.3 to +5.3; P=0.386).
  • Rescue-free completion was 86.9% with thiopental compared to 82.6% with dexmedetomidine (adjusted OR 0.72, 95% CI: 0.35–1.45), with moderate-to-severe adverse events occurring in 2.9% versus 0.9% of episodes, respectively.
  • Predefined bradycardia was more common with dexmedetomidine (39.4% vs. 24.8%) without perfusion compromise or need for intervention, while total sedation time remained similar (median 47 vs. 53 minutes; P=0.890).

Cite This Study

Shin et al. (2026) studied this question.

synapsesocial.com/papers/6a86b56c8a91293e6a1ccbf2https://doi.org/10.1097/pec.0000000000003674
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Intranasal dexmedetomidine as a single sedative agent for pediatric magnetic resonance imaging: a single-center observational cohort study2026
  2. 2Efficacy of dexmedetomidine as an adjuvant to propofol-based total intravenous anesthesia in children undergoing magnetic resonance imaging: A prospective randomized controlled trial2026
  3. 3Comparison of procedural sedation using dexmedetomidine and the combination of dexmedetomidine with S-ketamine during magnetic resonance examination of the endocranium in children2026
  4. 4Efficacy and Safety of Dexmedetomidine Compared to Other Needle-Free Pharmacological Sedation Methods in Pediatric Patients Undergoing Imaging Procedures2024 · 2 citations
  5. 5Pediatric sedation outside the operating room integrating dexmedetomidine for MRI and CT scan procedures: A systematic review2024 · 5 citations