A non-randomized controlled study of total intravenous anesthesia regimens for magnetic resonance imaging studies in children
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 m...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2019-01-01
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| Series: | Journal of Anaesthesiology Clinical Pharmacology |
| Subjects: | |
| Online Access: | http://www.joacp.org/article.asp?issn=0970-9185;year=2019;volume=35;issue=3;spage=379;epage=385;aulast=Balasubramanian |
| _version_ | 1819098049623883776 |
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| author | Bhuvaneswari Balasubramanian Anila D Malde Shantanu B Kulkarni |
| author_facet | Bhuvaneswari Balasubramanian Anila D Malde Shantanu B Kulkarni |
| author_sort | Bhuvaneswari Balasubramanian |
| collection | DOAJ |
| description | 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. After the loading dose of drugs, some children attained UMSS = 4 or progressive decline in heart rate, therefore, did not receive any infusion. The rest received either dexmedetomidine (0.7 μg/kg/h) (n = 35) or propofol (3 mg/kg/h) (n = 38) infusion for maintenance. Ketamine 0.25 mg/kg was used as rescue. Sedation failure was considered if either there was inability to complete the scan at the pre-set infusion rate, or there was need for >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. |
| first_indexed | 2024-12-22T00:24:48Z |
| format | Article |
| id | doaj.art-c5f709bdadf94cafa323e5a7733cc0b9 |
| institution | Directory Open Access Journal |
| issn | 0970-9185 |
| language | English |
| last_indexed | 2024-12-22T00:24:48Z |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Anaesthesiology Clinical Pharmacology |
| spelling | doaj.art-c5f709bdadf94cafa323e5a7733cc0b92022-12-21T18:45:05ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852019-01-0135337938510.4103/joacp.JOACP_289_17A non-randomized controlled study of total intravenous anesthesia regimens for magnetic resonance imaging studies in childrenBhuvaneswari BalasubramanianAnila D MaldeShantanu B KulkarniBackground 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. After the loading dose of drugs, some children attained UMSS = 4 or progressive decline in heart rate, therefore, did not receive any infusion. The rest received either dexmedetomidine (0.7 μg/kg/h) (n = 35) or propofol (3 mg/kg/h) (n = 38) infusion for maintenance. Ketamine 0.25 mg/kg was used as rescue. Sedation failure was considered if either there was inability to complete the scan at the pre-set infusion rate, or there was need for >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.http://www.joacp.org/article.asp?issn=0970-9185;year=2019;volume=35;issue=3;spage=379;epage=385;aulast=BalasubramanianAmbulatorydexmedetomidineketaminemagnetic resonance imagingpediatricpropofolsedation |
| spellingShingle | Bhuvaneswari Balasubramanian Anila D Malde Shantanu B Kulkarni A non-randomized controlled study of total intravenous anesthesia regimens for magnetic resonance imaging studies in children Journal of Anaesthesiology Clinical Pharmacology Ambulatory dexmedetomidine ketamine magnetic resonance imaging pediatric propofol sedation |
| title | A non-randomized controlled study of total intravenous anesthesia regimens for magnetic resonance imaging studies in children |
| title_full | A non-randomized controlled study of total intravenous anesthesia regimens for magnetic resonance imaging studies in children |
| title_fullStr | A non-randomized controlled study of total intravenous anesthesia regimens for magnetic resonance imaging studies in children |
| title_full_unstemmed | A non-randomized controlled study of total intravenous anesthesia regimens for magnetic resonance imaging studies in children |
| title_short | A non-randomized controlled study of total intravenous anesthesia regimens for magnetic resonance imaging studies in children |
| title_sort | non randomized controlled study of total intravenous anesthesia regimens for magnetic resonance imaging studies in children |
| topic | Ambulatory dexmedetomidine ketamine magnetic resonance imaging pediatric propofol sedation |
| url | http://www.joacp.org/article.asp?issn=0970-9185;year=2019;volume=35;issue=3;spage=379;epage=385;aulast=Balasubramanian |
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