Intravenous sedation for MR imaging of the brain and spine in children: pentobarbital versus propofol.

Abstract

The authors present a prospective study of single-agent pediatric sedation regimens for patients older than 2 years of age undergoing magnetic resonance (MR) imaging of the brain and spine. Thirty patients underwent MR imaging after intravenous administration of pentobarbital in successive boluses of 2.5 mg/kg to a maximum of 7.5 mg/kg. Thirty-one patients received an intravenous bolus followed by continuous infusion of propofol. The dosage schedule for propofol was 2 mg/kg (with supplemental 1 mg/kg boluses) followed by continuous infusion of 6 mg/kg per hour. There was no significant difference in the physiologic response to sedation between the two groups, although the magnitude of the drop in pulse was significantly greater in the group receiving propofol. Three patients receiving propofol experienced transient decreases in oxygen saturation, at variable times over the course of the procedure. However, patients recovered significantly faster from sedation with propofol. While propofol may represent a viable alternative to pentobarbital in selected patients, propofol requires constant physician supervision and meticulous technique.

Deep sedation with propofol for children undergoing ambulatory magnetic resonance imaging of the brain: Experience from a pediatric intensive care unit

“…In addition, dose-dependent cardiorespiratory depression has been reported (25,26). Rectal and intramuscular routes have been used to produce sedation for imaging studies in children, with variable success rates (27,28). In some children, oral, rectal, and intramuscular routes may not be successful in inducing adequate cooperation and immobilization for an MRI examination (24,27).…”

“…However, MRI examination poses many unique problems for the provision of inhalation anesthesia (28). Magnetic and radio frequency interactions between the scanner and anesthesia equipment may result in image degradation and interference with monitoring devices (1,2,28).…”

Propofol Anesthesia for Invasive Procedures in Ambulatory and Hospitalized Children: Experience in the Pediatric Intensive Care Unit

“…4,5 Propofol has been used extensively for pediatric anesthesia in the operating room with excellent success. 4 Because of its favorable properties and the limited anesthesia and operating room resources available in some centers, there has been increasing interest in the use of propofol anesthesia to facilitate procedures of short duration in children in areas outside of the operating room, such as for cardiac catheterization, 6 magnetic resonance imaging, 7 and elective cardioversion in the pediatric intensive care unit (PICU). 8 These experiences suggest that propofol is an effective anesthetic for these procedures but that important side effects, most notably respiratory depression and hypotension, may occur, necessitating close cardiorespiratory monitoring and the attendance of personnel skilled in cardiorespiratory support.…”

Comparison of propofol and thiopentone along with ketamine for paediatric MRI sedation

“…4 Propofol yields faster induction and faster emergence from sedation but it may cause hypotension. 5 Thiopentone I.V bolus has been used routinely 6 but the duration of recovery and sedation is unpredictable. 7 We aimed to study the effectiveness between Propofol and Thiopentone along with Ketamine and other premedications.…”