Efficacy of dexmedetomidine sedation by anesthesia technicians for pediatric MRI/CT procedures

Abstract

Background:
Pediatric magnetic resonance imaging (MRI) and computed tomography (CT) often require sedation to ensure diagnostic quality, yet traditional agents pose risks of respiratory depression and prolonged recovery. Dexmedetomidine, an alpha-2 adrenergic agonist, offers a favorable safety profile with minimal respiratory effects. In Saudi Arabia, the scope of anesthesia technicians administering sedation remains ambiguous. This systematic review evaluates the efficacy and safety of dexmedetomidine administered by trained anesthesia technicians for pediatric imaging.
Methods:
This systematic review followed PRISMA 2020 guidelines. Studies were identified through a comprehensive search of PubMed until  2025. Eligible studies included those reporting dexmedetomidine sedation administered by trained non-physician providers in pediatric patients undergoing MRI or CT. Data extraction and quality assessment were conducted independently by two reviewers. A narrative synthesis was performed due to heterogeneity among included studies.
Results:
Twelve studies involving 2,489 children were included. Reported sedation success rates ranged from 89% to 98%. The most common adverse events were transient bradycardia (5–15%) and hypotension (4–12%), which were self-limiting. No significant respiratory complications were observed. Non-physician-led sedation services demonstrated improved efficiency, with reduced imaging suite.
Conclusions:
Dexmedetomidine administered by trained non-physician providers is effective and safe for pediatric MRI and CT. Structured protocols can optimize sedation services and enhance workflow efficiency. Further multi-center prospective studies are warranted to strengthen the evidence base.