A non-randomized controlled study of total intravenous anesthesia regimens for magnetic resonance imaging studies in children

Abstract

Background and Aims: We studied the efficacy and safety of different total intravenous anesthesia used for pediatric magnetic resonance imaging (MRI). Material and Methods: Children of 1–7 years age (n = 88), undergoing MRI received a loading dose of dexmedetomidine 1 μg/kg over 10 min, ketamine 1 mg/kg, and propofol 1 mg/kg in sequence. University of Michigan Sedation Scale (UMSS) of 3 was considered an acceptable level for starting the scan. Rescue ketamine 0.25–0.5 mg/kg was given if UMSS remained 3 ketamine boluses or serious adverse events occurred. Statistical Package for Social Sciences 20 was used for analysis. Results: Initiation of scan was 100% successful with median induction time of 10 min. Maintenance of sedation was successful in 100% with dexmedetomidine and 97.4% with propofol infusion. Recovery time (25 min v/s 30 min), discharge time (35 min v/s 60 min), and total care duration (80 min v/s 105 min) were significantly less with propofol as compared to dexmedetomidine (P = 0.002, 0.000, and 0.000, respectively). There were no significant adverse events observed. Conclusion: Dexmedetomidine 1μg/kg, ketamine 1 mg/kg, and propofol 1 mg/kg provide good conditions for initiation of MRI. Although dexmedetomidine at 0.7μg/kg/h and propofol at 3 mg/kg/h are safe and effective for maintenance, propofol provides faster recovery.

Keywords

• Ambulatory
• dexmedetomidine
• ketamine
• magnetic resonance imaging
• pediatric
• propofol
• sedation