Comparison of Propofol With Pentobarbital/Midazolam/Fentanyl Sedation for Magnetic Resonance Imaging of the Brain in Children

Pershad, Jay; Wan, Jim Y.; Anghelescu, Doralina L.

doi:10.1542/peds.2006-3108

Cited by 78 publications

(53 citation statements)

References 39 publications

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“…The conventional doses of Propofol used for induction and maintenance of sedation for paediatric MRI 2-6 mg/kg and 100-200 μgm/kg/min respectively. 9 These doses sometimes cause adverse effect like apnoea, injection site pain, involuntary movement and hypotension. 10 Tomatir et al reported that, use of small dose of Ketamine 0.5 mg/kg allows successful scan completion with lower induction and maintenance doses of propofol beside haemodynamic stability.…”

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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Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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“…The optimal delivery of sedation is accomplished by clinician strained in anesthesia. Their experience would allow them to identify and utilize the best available drugs and techniques to full potential to obtain the optimal outcome [6][7][8]10,12,15,19,20]. This would enhance patient safety and also result in studies yielding data with comparable methodologies, skills, and techniques.…”

Section: Proposal For Solutionmentioning

confidence: 99%

“…The Ramsay score 21has been recommended; itis a well-known and frequently applied scoring system, used for documentation of adequate depth of sedation [7,13,20,22].…”

Section: Proposal For Solutionmentioning

confidence: 99%

Role Of Anaesthetist In Sedation For Diagnostic Procedures: The Glass Is Half Empty? A Narrative Review

Pasqualucci¹,

Nadhari²,

Vaidyan³

et al. 2017

SOJAPM

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Sedation of outpatients undergoing diagnostic and therapeutic procedures remains a controversial topic, and there remains a paucity of literature and guidelines to help inform sound clinical decisions. As these are frequently performed procedures that offer advantages to patients in terms of their comfort and well-being, we aimed to better address this information deficit and to clarify why appropriate guidelines are still not available. To this end, we propose reviewing sedation procedures performed using Magnetic Resonance Imaging (MRI) in pediatric patients.

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“…There was no evidence of hypoperfusion in the subjects who experienced propofol-induced hypotension by the aforementioned criteria, a fi nding that is consistent with previous studies. 5,34 The aforementioned physical signs are subjective measures, however, with signifi cant interrater variability, which reduces their reliability.…”

Section: Figurementioning

confidence: 99%

A Presedation Fluid Bolus Does Not Decrease the Incidence of Propofol-Induced Hypotension in Pediatric Patients

Jager

Aldag²,

Deshpande

2015

Hospital Pediatrics

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Comparison of Propofol With Pentobarbital/Midazolam/Fentanyl Sedation for Magnetic Resonance Imaging of the Brain in Children

Abstract: Propofol permits faster onset and recovery than, and comparable efficacy to, a pentobarbital/midazolam/fentanyl regimen for sedation of children for MRI.

Cited by 78 publications

References 39 publications

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

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

Role Of Anaesthetist In Sedation For Diagnostic Procedures: The Glass Is Half Empty? A Narrative Review

A Presedation Fluid Bolus Does Not Decrease the Incidence of Propofol-Induced Hypotension in Pediatric Patients

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