The Effectiveness of Three Regimens of Sedation for Children Undergoing Magnetic Resonance Imaging: A Clinical Study.

Abstract

Background: Magnetic resonance imaging (MRI) under sedation requires faster recovery for early discharge and feeding resumption in children with neuropsychiatric disorders. The use of dexmedetomidine alone results in delayed recovery. Propofol, when used alone, can cause hypotension and respiratory depression. A new regimen for sedation was evaluated by exploiting the properties of these drugs, to allow faster recovery with minimal adverse events.

Materials and methods: One hundred and fifty children aged 2-12 years requiring MRI were randomly allocated to these three groups. Group P (n = 50) received propofol bolus at 2 mg.kg^-1 over 10 min followed by infusion at 100 μg.kg^-1.min^-1. Group D (n = 50) received dexmedetomidine bolus of 2 μg.kg^-1 over 10 min followed by infusion at 1 μg.kg^-1.h^-1. Group PD (n = 50) received propofol bolus at 2 mg.kg^-1 over 10 min followed by dexmedetomidine infusion at 1 μg.kg^-1.h^-1. Recovery characteristics were noted.

Results: Recovery following sedation in Group PD (15 ± 7.0 min) and Group P (17.35 ± 7.4 min) were comparable and significantly (P = 0.03) lesser than Group D (27.58 ± 8.09 min). Emergence delirium scores were significantly less in Group PD (5 ± 1.08) and Group D (5.6 ± 2.4), unlike scores in Group P (9 ± 2.43). About 79.5% (39/49) of children in Group P, 88.2% (45/51) of children in Group D, and 86% (43/50) of children in Group PD completed MRI without any movement. Seven (14.58%) in Group P, 2 (4%) in Group D, and 5 (10.20%) in Group PD required rescue sedation.

Conclusion: The regimen with propofol bolus and dexmedetomidine infusion provided adequate sedation and better recovery characteristics in children aged 2-12 years without systemic complications, as compared to the use of either agent alone.