Propofol vs pentobarbital for sedation of children undergoing magnetic resonance imaging: results from the Pediatric Sedation Research Consortium

Abstract

Among institutions contributing data to the PSRC, it is found that propofol provides more efficient and effective sedation than pentobarbital for children undergoing MRI. Although apnea occurred with a greater frequency in patients who received propofol, the rate of apnea and airway complications for propofol was not statistically different from that seen in patients who received pentobarbital.

Propofol Anesthesia for Children Undergoing Magnetic Resonance Imaging

“…However, the frequency of adverse airway events is consistent with those reported for the 2 anesthetics. 2,16,17,19 In the case of propofol with nasal cannula, avoiding a supraglottic airway may reduce the frequency of upper airway adverse events. Furthermore, in a model of upper airway irritability using saline to trigger apnea and laryngospasm, the incidence of acute airway responses during propofol anesthesia was significantly less than during sevoflurane anesthesia, independent of the depth of anesthesia.…”

Comparison of Dexmedetomidine With Pentobarbital for Pediatric MRI Sedation

“…7,8,30 Propofol appears to be more effi cient because it results in fewer inadequate sedations and allows patients a much shorter recovery time. However, the use of propofol for sedation outside the operating room is controversial, because of the drug's potential for rapid, profound changes in sedation/depth of anesthesia, respiratory depression, transient apnea, and hypotension, as well as the lack of antagonist medications.…”

“…[4][5][6] Propofol is often used to sedate children in preparation for MRI because of its predictability, rapid onset, and offset of action. 6,7 In many institutions, only anesthesiologists can administer propofol. In these restricted-use settings, dexmedetomidine might be an alternative for sedation.…”

Sedation for Pediatric Patient with End-Stage Hepatic Disease Outside Operating Room

“…Informed consent, verbal and written instructions, the child's medical history of anesthetic importance, physical exam is necessarily steps. At the end a risk assessment according to American Society of Anaesthesia (ASA) physical status classification system is defined fort the patient [10]. Liver disease may impair the metabolism of drugs used for sedation.…”