Oral Dexmedetomidine in Pediatric MRI

NCT ID: NCT05619627

Last Updated: 2025-12-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

PHASE1

Total Enrollment

18 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-02-01

Study Completion Date

2027-05-31

Brief Summary

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The objective of this preliminary study is to assess the utility of oral dexmedetomidine as the sole sedative agent in pediatric population undergoing MRI.

Detailed Description

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MRI is an important and robust medical imaging technique that has become the cornerstone for radiologic studies. Superior image quality and resolution especially for soft tissue imaging, without the use of ionizing radiation, has made MRI a dominant imaging modality in pediatrics. Despite its many advantages, MRI is not child friendly. Lengthy scan times, the need for lying motionless in a confined space, excessive noise and vibration during image acquisition, are all factors that have made anesthesia an integral part of pediatric MRI.

General anesthesia is a state of medically induced unconsciousness, analgesia and muscle relaxation which is required for most invasive medical procedures. Despite being painless, MRI scans are highly susceptible to motion artifact and require a state of immobility that may not be obtainable in awake uncooperative children. While very safe, general anesthesia carries potential risk of serious morbidity and mortality secondary to aspiration during instrumentation of the airway, hypoxia and hypoventilation secondary to laryngospasm/bronchospasm and hemodynamic instability. Therefore, sedation may be an appropriate technique to offer anxiolysis, amnesia and immobility while maintaining airway reflexes with limited impact on ventilation and hemodynamics for non-stimulating procedures such as imaging. Aside from having a more favorable risk/benefit profile as compared to general anesthesia when it comes to radiologic studies, sedation is also less costly and burdensome on anesthesia departments and could provide immense cost-saving measures for healthcare institutions at large.

While there are many intravenous (IV) sedatives, establishing IV access while awake could be very traumatizing, leaving a lasting negative impression of the healthcare environment in a child's mind. Hence, enteral medications may be more acceptable and child friendly. This is especially valuable in patients who require repeated surveillance imaging and who demonstrate heightened level of anxiety and fear with each visit. Among sedative agents that could be administered enterally, dexmedetomidine may be superior due to minimal respiratory depression while providing anxiolysis and analgesia. Of note, dexmedetomidine is a highly selective alpha2-adrenoreceptor agonist that exerts its hypnotic action through activation of central pre- and postsynaptic alpha2-receptors in the locus coeruleus, mimicking natural sleep.

Conditions

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Anesthesia

Keywords

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Oral dexmedetomidine

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Prospective Pilot Study, Single-site, open-label, phase I dose escalation trial
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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General anesthesia

Control group: Subjects will receive general anesthesia for their MRI

Group Type ACTIVE_COMPARATOR

General Anesthesia (control group)

Intervention Type DRUG

Participants will receive general anesthesia for their MRI

Dexmedetomidine 10 mcg/kg

Group Four: Subjects will receive oral dexmedetomidine 10 mcg/kg 2 hours prior to MRI

Group Type EXPERIMENTAL

Dexmedetomidine

Intervention Type DRUG

Participants will receive oral dexmedetomidine as the sole sedative agent for undergoing MRI

Dexmedetomidine 12 mcg/kg

Group Five: Subjects will receive oral dexmedetomidine 12 mcg/kg 2 hours prior to MRI

Group Type EXPERIMENTAL

Dexmedetomidine

Intervention Type DRUG

Participants will receive oral dexmedetomidine as the sole sedative agent for undergoing MRI

Dexmedetomidine 4 mcg/kg

Group One: Subjects will receive oral dexmedetomidine 4 mcg/kg 2 hours prior to MRI

Group Type EXPERIMENTAL

Dexmedetomidine

Intervention Type DRUG

Participants will receive oral dexmedetomidine as the sole sedative agent for undergoing MRI

Dexmedetomidine 6 mcg/kg

Group Two: Subjects will receive oral dexmedetomidine 6 mcg/kg 2 hours prior to MRI

Group Type EXPERIMENTAL

Dexmedetomidine

Intervention Type DRUG

Participants will receive oral dexmedetomidine as the sole sedative agent for undergoing MRI

Dexmedetomidine 8 mcg/kg

Group Three: Subjects will receive oral dexmedetomidine 8 mcg/kg 2 hours prior to MRI

Group Type EXPERIMENTAL

Dexmedetomidine

Intervention Type DRUG

Participants will receive oral dexmedetomidine as the sole sedative agent for undergoing MRI

Interventions

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Dexmedetomidine

Participants will receive oral dexmedetomidine as the sole sedative agent for undergoing MRI

Intervention Type DRUG

General Anesthesia (control group)

Participants will receive general anesthesia for their MRI

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Participants 3-6 years old, male and female, all races and ethnicities
2. Requiring a clinically indicated MRI with general anesthesia

Exclusion Criteria

1. Refusal to take oral dexmedetomidine
2. Known allergy to dexmedetomidine
3. Inability to take dexmedetomidine at least 90 minutes prior to start of the MRI
4. Medical contraindications to administration of dexmedetomidine including:

1. Unstable cardiac status including life threatening arrhythmias, abnormal cardiac anatomy, significant cardiac dysfunction
2. Current use of digoxin
3. Moya Moya disease
4. New onset stroke
5. American Society of Anesthesiologists (ASA) physical status classification \> II
6. Contraindications to administering sedation including:

1. Active and uncontrolled gastroesophageal reflux
2. Active and uncontrolled vomiting
3. Current or recent history of apnea
4. Active respiratory disease including pneumonia, bronchitis, respiratory syncytial virus infection, asthma exacerbation
5. Craniofacial anomalies
7. Inability to have MRI scans
8. Non-English speaking volunteers
Minimum Eligible Age

3 Years

Maximum Eligible Age

6 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Soroush Merchant

OTHER

Sponsor Role lead

Responsible Party

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Soroush Merchant

Director of Medical Pain Service, Principal Investigator, Assistant Professor of Anesthesiology, MD, MS

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Soroush Merchant, MD, MS

Role: PRINCIPAL_INVESTIGATOR

Children's Mercy Hospital Kansas City

Locations

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Children's Mercy Hospital

Kansas City, Missouri, United States

Site Status

Countries

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United States

Central Contacts

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Soroush Merchant, MD, MS

Role: CONTACT

Phone: 816-3018595

Email: [email protected]

Kelsye Howell, MSN, RN

Role: CONTACT

Phone: 816-760-5919

Email: [email protected]

Facility Contacts

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Soroush Merchant, MD, MS

Role: primary

References

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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Mason KP, Green SM, Piacevoli Q; International Sedation Task Force. Adverse event reporting tool to standardize the reporting and tracking of adverse events during procedural sedation: a consensus document from the World SIVA International Sedation Task Force. Br J Anaesth. 2012 Jan;108(1):13-20. doi: 10.1093/bja/aer407.

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Reference Type BACKGROUND
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Other Identifiers

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STUDY00002526

Identifier Type: -

Identifier Source: org_study_id