Evaluation of the Efficacy of Propofol-Magnesium Sulfate Combination for Sedation in Paediatric Magnetic Resonance Imaging of Brain.- a Randomized Controlled Trial

Abstract

Background and Aims:The key to successful sedation for pediatric magnetic resonance imaging (MRI) is to keep the child completely immobile while ensuring rapid recovery. We compared the efficacy of propofol-midazolam and propofol-magnesium sulfate sedation for MRI of the brain in the paediatric population. Methods: Total 60 paediatric patients, aged 1 to 8 years awaiting for MRI brain were randomly allocated into two groups. Group I patients received midazolam 0.05mg/kg and Group II patients received magnesium sulfate 30 mg/kg infusion in the preinduction room. In the MRI room all patients were sedated with 1-2 mg/kg bolus and 100 ug/kg/min infusion of propofol. The two groups were compared for sedation characteristics like discharge time, total number of additional propofol boluses, agitation scores, haemodynamic parameters and adverse events. Fisher exact test was used for all quantitative data. Results: Induction time, scan quality, requirement of additional propofol boluses and awakening time were comparable for the groups (P>0.05). There was no statistically significant incidence of airway instrumentation between both groups (p=0.14). ). Heart rate remained on lower normal side, 20 minutes after induction in Group II (P<0.00). Incidence of emergence agitation was significantly lower in Group II (P<0.01). The discharge time was shorter in Group II (41.03 ± 8.39 min versus 32.83 ± 5.97 min;P<0.001). Conclusion: Propofol-magnesium sulfate sedation is a better alternative to propofol-midazolam combination for paediatric brain MRI, as it provides a shorter discharge time and a lower incidence of emergence agitation.