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BJA Advance Access originally published online on June 4, 2008
British Journal of Anaesthesia 2008 101(2):239-243; doi:10.1093/bja/aen153
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Propofol-based sedation regimen for infants and children undergoing ambulatory magnetic resonance imaging

A.-M. Machata*, H. Willschke, B. Kabon, S. C. Kettner and P. Marhofer

Department of Anaesthesia, General Intensive Care and Pain Therapy, Medical University of Vienna, General Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria

* Corresponding author. E-mail: anette-marie.machata{at}meduniwien.ac.at

Background: Propofol is widely used for infants and children requiring sedation for magnetic resonance imaging. However, increased doses of propofol may quickly lead to an unintended deep sedation and respiratory depression. Thus, an appropriate low dosage, which nevertheless ensures sufficient sleep for successful magnetic resonance imaging (MRI) completion, would probably minimize respiratory adverse events. We investigated the safety and efficacy of a low-dose propofol-based sedation regimen in a broad age range of children.

Methods: We investigated 500 infants and children, prospectively. Premedication consisted of i.v. midazolam 0.1 mg kg–1. Sedation was induced with i.v. nalbuphine 0.1 mg kg–1 and propofol 1 mg kg–1, and maintained with propofol 5 mg kg–1 h–1. Outcome measures were induction time, sedation time, recovery time, need for additional sedation, respiratory events, cardiovascular events, paradoxical reactions, and sedation failure.

Results: Data were obtained from 53 infants and 447 children. Median (IQR) age was 5.3 (4.5, 6.1) yr and body weight was 19.3 (16.5, 24.7) kg. The induction time was 2 (1, 2) min, sedation time 55 (45, 65) min, and recovery time 8 (8, 9) min. Additional sedation was necessary in 11 patients (2.2%), mild respiratory events occurred in five patients (1%). All MRI examinations could be completed without paradoxical reaction or sedation failure.

Conclusion: This sedation regimen provides the shortest induction time so far described, a rare demand for additional sedation, a low incidence of respiratory events, and a rapid recovery.

Keywords: anaesthesia, paediatric; anaesthetic techniques, i.v. bolus; anaesthetics i.v., propofol; brain, magnetic resonance imaging; sedation


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Propofol for MRI Sedation: The Ideal Anesthetic!
Alan Bielsky, et al.
British Journal of Anaesthesia, 20 Jul 2008 [Full text]
Propofol based sedation of MRI: be cautious in neonates
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British Journal of Anaesthesia, 15 Sep 2008 [Full text]

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