Deep sedation with propofol for children undergoing ambulatory magnetic resonance imaging of the brain: experience from a pediatric intensive care unit

Rashed A Hasan, Jay R Shayevitz, Vipul Patel
Pediatric Critical Care Medicine 2003, 4 (4): 454-8

OBJECTIVES: Use of intravenous propofol sedation to facilitate completion of magnetic resonance imaging of the brain in children.

DESIGN: Retrospective, cross-sectional.

SETTING: A university-affiliated pediatric intensive care unit.

PATIENTS: A total of 115 children who received intravenous propofol to complete magnetic resonance imaging of the brain January 1 through December 31, 2001.

INTERVENTIONS: Intravenous propofol infusion.

MEASUREMENTS AND MAIN RESULTS: The mean age was 4.2 +/- 3.1 yrs, and there were 63 boys and 52 girls. Sixty-nine percent of patients belonged to ASA physical status class I, and 31% belonged to ASA class II. All studies were completed with satisfactory image quality. The total dose of propofol used to complete a magnetic resonance image of the brain was 4.3 +/- 1.7 mg/kg body weight. The mean duration of sedation induction was 4.5 +/- 3.5 mins. The mean time to recovery (from the end of the procedure) was 20 +/- 15 mins. The duration of the procedure averaged 39 +/- 20 mins, and the time to discharge from the hospital was 50 +/- 21 mins from the end of the procedure. No episodes of hypoxia, apnea, or a need for artificial airway were noted. Systolic blood pressure decreased 10% +/- 13%, but none of the patients met the criteria for hypotension. A telephone call the next day to the family did not reveal any delayed complications.

CONCLUSIONS: Propofol can safely facilitate ambulatory magnetic resonance imaging of the brain in children, and it is associated with brief induction, recovery, and discharge times from the hospital. A drop in blood pressure, although mild and transient, does occur. Therefore, appropriate monitoring and preparedness for cardiorespiratory support are essential.

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