A Comparison of the Sedative, Hemodynamic, and Respiratory Effects of Dexmedetomidine and Propofol in Children Undergoing Magnetic Resonance Imaging

Köroğlu, Ahmet; Teksan, H.; Sağır, Özlem; Yücel, Aytaç; Toprak, Hüseyin; Ersoy, Özcan

doi:10.1213/01.ane.0000219592.82598.aa

Cited by 230 publications

(161 citation statements)

References 24 publications

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“…In contrast, other sedatives like propofol and benzodiazepines can cause severe respiratory depression at clinical dosage. Therefore, we used dexmedetomidine and ketamine for sedation because we thought that the continuous infusion of dexmedetomidine and ketamine could preserve self-respiration better than the continuous infusion of propofol or benzodiazepines during operation (26,27). Moreover, in a comparison of dexmedetomidine and propofol for intraoperative sedation, dexmedetomidine showed a slower onset of sedation, but resulted in less pain during the postoperative period due to its analgesicsparing effect (28).…”

Section: Discussionmentioning

confidence: 99%

Non-intubated thoracoscopic bullectomy under sedation is safe and comfortable in the perioperative period

et al. 2018

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Background: Non-intubated thoracoscopic surgery can be performed under sedation using adjuvant regional anesthesia, however, the benefits of non-intubated thoracoscopic surgery under sedation have not yet been completely verified. In this study, we compare the perioperative safety and pain complaints of sedation without intubation in thoracoscopic bullectomy with that of conventional general anesthesia with double-lumen intubation and mechanical ventilation. Methods: Forty-one patients with primary spontaneous pneumothorax who were scheduled for thoracoscopic bullectomy were enrolled in this study. Twenty-one patients were under sedation anesthesia (SA group) and 20 patients were under general anesthesia (GA group). In SA group, sedation was done with dexmedetomidine (a loading dose of 1 μg/kg for 10 min and then maintained in dosages of 0.3-1 μg/kg/h) and ketamine (2-4 mg/kg/h intraoperatively). Meanwhile, in GA group, induction with propofol and rocuronium, intubation with double lumen endotracheal tube and maintenance with 1.0-2.5% sevoflurane was done. In both groups, thoracoscopic bullectomy was performed in the same manner and all operations were conducted by single surgeon. Time for anesthesia [including emergence time and post-anesthesia care unit (PACU) recovery time] and operation, postoperative pain, sore throat, hoarseness, adverse events (nausea, vomiting, hypotension and bradycardia), dose of rescue analgesic drug used for 24 hours post-operatively and perioperative arterial blood gas analysis were recorded. Results: The times for anesthesia, operation and emergence were significantly shorter in SA than GA.Incidence of sore throat were significantly lower in SA. The difference of other adverse events in the two groups was not significant. Conclusions:Our study demonstrated that compared to double-lumen intubation with general anesthesia, non-intubation with sedation for bullectomy for primary spontaneous pneumothorax was safe and efficient to reduce perioperative time.

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Section: Discussionmentioning

confidence: 99%

Non-intubated thoracoscopic bullectomy under sedation is safe and comfortable in the perioperative period

et al. 2018

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“…21 Koroglu reported incidence of desaturation with Propofol during MRI. 22 Upper air way collapsibility is markedly increased in both sleeping and anesthetized children. 23 Propofol and barbiturate can exacerbate upper air way obstruction and increase the risk of respiratory depression/apnoea.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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INTRODUCTIONMagnetic resonance imaging (MRI) requires the patient to stay still for at least 15 minutes to one hour in a noisy and claustrophobic environment. It is difficult especially in infants and children without drug induced sleep. Hence anaesthesiologists are discovering safe and successful combination of drugs. 1Propofol is discussed to be a best of all intravenous (I.V.) drugs for paediatric sedation because of its faster induction and quick recovery.2 Magnetic resonance imaging scanning for children is a big challenge for anaesthesiologist for providing adequate sedation without compromising airway and haemodynamics. 3 The success of sedation during MRI is typically assessed by two factors 1) safety during sedation 2) successful completion of test that is good quality of radiological image without artefacts. It can be achieved from motion less body during scan. 4 Propofol yields faster induction and faster emergence from sedation but it may cause hypotension. 5Thiopentone 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. ABSTRACTBackground: Children are very much scared to undergo magnetic resonance imaging (MRI) brain or any body part even along with their parents for about 15 to 25 minutes. We investigated the combination of Propofol Ketamine and Thiopentone Ketamine along with Glycopyrolate and Midazolam premedication to see safe and better sedation group for paediatric MRI. Methods: We investigated randomly 50 children of age three to five years prospectively. Children were premedicated with Glycopyrolate 0.01 mg/kg and Midazolam 0.05 mg/kg per body weight intravenously. Ketamine 1 mg/kg body weight was given just before shifting into the MRI machine. After body positioning either Propofol (PK group) or Thiopentone (TK group) 1 mg/kg body weight was given slowly. Children were monitored for electrocardiogram (ECG), arterial oxygen saturation (SpO 2 ) and respiratory rate continuously. Oxygen supplementation was through the oxygen (O 2 ) mask. Three parameters were studied 1) Repetition of drug 2) Respiratory distress during scan period and 3) Recovery time. Results: The pre-interventional characteristics including age, sex, weight, ASA grade, were comparable between two groups (p>0.050). Repetition in PK group was high compared to TK group (40% vs 8%; p=0.0081). Respiratory distress was comparable in both the groups (16% vs 24%; p=0.480) whereas recovery time was significantly shorter for PK group (4.62 ± 0.53 vs 9.86 vs 1.28; p<0.001). Conclusions: Thiopentone Ketamine combination results in lower repetition rate while Propofol Ketamine offers shorter recovery period. However, respiratory distress is almost similar.

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“…Propofol ile karşılaştırıldığında, deksmedetomidin ile sağlanan sedasyonun, çocuk ve erişkinlerde arter oksijen satürasyonunu daha iyi koruduğu gözlenmiştir (19,22).…”

Section: Discussionunclassified

Comparison of Dexmedetomidine and Midazolam in Sedation for Percutaneous Hepatic Hydatid Cyst Drainage

Bavullu¹,

Aksoy²,

Abdullayev³

et al. 2013

Turk J Anesth Reanim

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Özgün Araştırma / Original Article 195Objective: Hydatid cyst still continues to be a public health problem. The basic treatment for the disease is surgery, but USG-guided percutaneous drainage has become an important treatment alternative. Agents preferred for sedation during drainage performed under local anaesthesia must also preserve respiration and haemodynamic stability while providing adequate sedation. We used midazolam, which has a short duration of action, and a selective α 2 adrenergic receptor agonist, dexmedetomidine, and compared them regarding their sedative properties and intraoperative complications. Methods:After approval by the clinical trials ethics committee, 40 patients with similar demographic data were randomized into two groups. All patients received 10 mg metochlopramide and 45.5 mg phenyramine before the procedure. Then midazolam (0.07 mg kg -1 iv bolus followed by 0.01 mg kg -1 h -1 infusion) was administered to Group 1, and dexmedetomidine (1 µg kg -1 loading dose in 10 minutes, followed by 0.2 µg kg -1 h -1 continuous infusion) was administered to Group 2 for sedation. Just before the surgical procedure, all patients received propofol in a subhypnotic dose of 0.5 mg kg -1 iv. Propofol 0.5 mg kg -1 iv was administered to patients in each group if there was no adequate sedation. OAA/S and BIS scales were used to evaluate the sedation level during the procedure. HR, MAP, RR, SpO 2 and ETCO 2 values were monitored before and after induction and every 5 minutes thereafter. The propofol requirement was noted for each group.Results: Sedation in the dexmedetomidine group was as effective and adequate as that observed with the midazolam group. BIS values were significantly low in the dexmedetomidine group, especially after 10 minutes and thereafter. Respiratory rate, SpO 2 , and ETCO 2 values were similar in both groups, whereas clinically insignificant decreases in HR and MAP were observed in the dexmedetomidine group. Propofol requirements were similar in both groups. Conclusion:We conclude that dexmedetomidine can be an appropriate agent in surgical procedures performed under local anaesthesia, providing adequate sedation without respiratory depression.Key Words: Dexmedetomidine, midazolam, sedation Amaç: Kist hidatik hala önemli bir sağlık sorunu olmaya devam etmektedir. Temel tedavisinin cerrahi olması ile birlikte, günümüzde ultrasonografi eşliğinde yapılan perkütan drenaj da önemli bir tedavi alternatifi haline gelmiştir. Lokal anestezi altında yapılan bu işlem sırasında, sedasyon için tercih edilecek ajanlar, hastada yeterli sedasyonu sağlamanın yanı sıra solunumu ve hemodinamiyi en az düzeyde etkileyecek özellikte olmalıdır. Çalışmamızda kısa etkili bir benzodiazepin olan midazolamı ve α 2 selektif adrenerjik reseptör agonisti deksmedetomidini kullanarak, bu ajanları sedasyon derinliği ve intraoperatif komplikasyonlar açısından karşılaştırdık.Yöntemler: Etik kurul onayı ve hasta onamı alındıktan sonra demografik verileri benzer 40 hasta, randomize iki gruba ayrıldı. İşlem öncesi her...

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A Comparison of the Sedative, Hemodynamic, and Respiratory Effects of Dexmedetomidine and Propofol in Children Undergoing Magnetic Resonance Imaging

Cited by 230 publications

References 24 publications

Non-intubated thoracoscopic bullectomy under sedation is safe and comfortable in the perioperative period

Non-intubated thoracoscopic bullectomy under sedation is safe and comfortable in the perioperative period

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

Comparison of Dexmedetomidine and Midazolam in Sedation for Percutaneous Hepatic Hydatid Cyst Drainage

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