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Procedural sedation for MRI in children with ADHD
Author(s) -
Kitt Eimear,
Friderici Jennifer,
Kleppel Reva,
Canarie Michael
Publication year - 2015
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.12721
Subject(s) - medicine , sedation , propofol , sedative , midazolam , demographics , magnetic resonance imaging , population , pediatrics , anesthesia , radiology , demography , environmental health , sociology
Summary Background Attention‐deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood, affecting 5–8% of children. It has been observed that these children have poor sedation experiences; however, to date there is minimal research on procedural sedation in this population. Aim To examine whether children with ADHD required larger doses of propofol for magnetic resonance imaging (MRI) sedation. Methods The hospital's administrative billing database was used to identify all billing codes for MRI brain scans (with and without contrast) in children aged between 5 and 12 years over the preceding 5.5 years. The hospital's electronic medical record database provided baseline demographics. The sedation record was reviewed for propofol dose, psychostimulant use, and prescribed dose. All children received a standard weight‐based dose of midazolam prior to receiving the necessary amount of propofol. Primary outcome was the dose of propofol administered (mg·kg −1 ) to achieve adequate sedation. Results A total of 258 procedures met the inclusion criteria. The sample was 52% male, 74% White, 7.8% Black, 7.8% Hispanic, 4.3% Asian, and 6.2% other. ADHD was documented for 49 procedures with a prevalence of 18.5%. Patients with ADHD were older, more likely to be male, Hispanic, or to report race as ‘Refused/Unknown’. Indications for MRI for patients with ADHD varied significantly, with ‘Behavioral’ and ‘Neurocutaneous’ being significantly overrepresented in the ADHD group. The average sedative dose for all patients was 2.8 mg·kg −1 (95% CI 2.62–2.94). Sedative dose was similar among children with and without ADHD diagnosis. Conclusions Our study illustrates that children with ADHD do not have higher sedative requirements to achieve a successful brain MRI .