Dexmedetomidine for pediatric MRI sedation: a review of a series of cases.

BACKGROUND: The aim of this review was to determine whether dexmedetomidine alone provided satisfactory conditions for children undergoing magnetice resonance imaging (MRI).

METHODS: A retrospective review of 21 patients was undertaken, (age range: 1-8 years, weight 10-27 kg) who received dexmedetomidine to provide deep sedation for an MRI procedure.

RESULTS: In the initial eight patients who received dexmedetomidine (bolus 0.5-1.5 mg.kg(-1) and infusion rate 1-1.5 mg.kg(-1).h(-1)) by itself, movement occurred in five of them, even when the maximum suggested dose was used (1 microg.kg(-1).h(-1)). Midazolam (0.1 mg.kg(-1)) i.v. was given as an adjunct to the following 13 patients (dexemdetomidine doses were lower: bolus 1 mg.kg(-1), infusion 0.5-1 mg.kg(-1).h(-1)). Only one patient moved within this group. The mean time to discharge postprocedure was 90 min. There were no differences with respect to recovery or discharge times between those who did or did not receive midazolam. No cardiac or respiratory complications were noted.

CONCLUSIONS: The use of dexmedetomidine for MRI sedation by itself was more unpredictable than anticipated from the published case reports of its use.