Effectiveness of Three Regimes of Sedation in Children for Magnetic Resonance Imaging: A Clinical Trial

Abstract

as a part of stem cell therapy with age > 5 years were included. Patients unwilling for consent and patients requiring general anesthesia were excluded. Drugs and dosages used were noted. Hemodynamic parameters were noted every 5 minutes. Sedation levels were monitored using Ramsay sedation score every 10 minutes. Statistical analysis was done using the unpaired "t" test and p value of < 0.05 was considered significant.Results: The age range was from 6 to 32 years with average of 11.59 years. Most commonly used drugs for procedural sedation were midazolam, dexmedetomidine infusion, and ketamine. Hemodynamic stability was maintained in all patients. Respiratory rate and end-tidal CO 2 were maintained close to baseline (p > 0.05). No cardiorespiratory adverse events were noted.Conclusion: Dexmedetomidine and ketamine provide good procedural sedation without causing cardiorespiratory depression, maintain airway reflexes, and offer adequate analgesia along with local anesthesia. The study subject draws attention to an often-neglected area and has scope for change in future practice.Introduction: Anesthesia in Duchenne muscular dystrophy (DMD) poses many challenges, because of poor cardiorespiratory function, weak airway muscles, macroglossia, or obstructive sleep apnea. The present study was undertaken to evaluate safety as well as efficacy of procedural sedation techniques, and to assess the effect on hemodynamic and respiratory parameters in patients of DMD.Methodology/Description: The present prospective, observational study was performed in 54 consecutive male patients of DMD presenting for stem cell therapy. After institutional ethics committee approval, patients coming for elective bone marrow aspiration and intrathecal catheterization S15 Abstracts Journal of Neuroanaesthesiology and Critical Care Vol. 5 No.1/2018 limbs (p < 0.05). Overall success rate of MEP recordings was higher in upper limbs. The current and stimulating pulse needed to elicit responses was also higher in lower limbs. Limitations: single institutional study, smaller sample size.Conclusion: Thus, propofol-based anesthesia appears to suppress MEP recordings in lower limbs as compared with upper limbs. Introduction:Intraoperative-neurophysiological monitoring (IONM) is important to delineate the epileptogenic lesions from the eloquent cortex. Many anesthetic agents have significant interference in monitoring of electrocorticography (ECoG), somatosensory evoked potentials (SSEPs), and motor evoked potentials (MEPs). Complete relaxation with moderate depth is needed for ECoG, while muscle relaxation will not elicit MEP. Hence, a narrow balance is required to conduct recording of ECoG, SSEP, and MEP simultaneously. Here, we present successful management of two such cases under general anesthesia where judicious use of anesthetic agents provided least interference to IONM. Methodology/Description: A 7-year-old child presented with premotor cortical dysplasia posted for right frontotemporal craniotomy. Aim was to develop anesthetic technique to eli...