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A retrospective comparison of propofol alone to propofol in combination with dexmedetomidine for pediatric 3T MRI sedation
Author(s) -
Boriosi Juan P.,
Eickhoff Jens C.,
Klein Kristi B.,
Hollman Gregory A.
Publication year - 2017
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.13041
Subject(s) - dexmedetomidine , medicine , propofol , sedation , anesthesia , retrospective cohort study , surgery
Background and aim Both propofol and dexmedetomidine have been found to be safe and effective sedation for magnetic resonance imaging ( MRI ). Our program experienced an increase in patients arousing and experiencing an adverse airway event during propofol sedation for MRI in the first months of using a new 3T (Tesla) MRI scanner that was found to have a longer reverberation time compared to the previous 1.5 T MRI . In an effort to decrease patient arousal and adverse airway events during MRI , we administered a dexmedetomidine load prior to our standard propofol protocol. The objective was to compare adverse events and other outcome measures of patients sedated with propofol alone (Pro) and propofol preceded by a dexmedetomidine load (D+P). Methods We reviewed a sedation database and medical records for all children undergoing 3T MRI studies while sedated with propofol alone or propofol preceded by a dexmedetomidine load in 2014. Results Two hundred and fifty‐six sedations were performed for MRI (87 Pro and 169 D+P). The two groups were comparable with regard to age, weight, gender, and American Society of Anesthesiologists status. Subjects in the D+P cohort had significantly fewer adverse events (10/169 patients (5.9%) vs 23/87 patients (26.4%) [ OR 0.18, 95% CI : 0.08–0.39, P < 0.001]), particularly upper airway obstruction. Mean discharge time was longer in the D+P cohort compared to the Pro cohort (87.1, SD 26.3 min vs 69.7, SD 23.6; [mean difference 17.7 min, 95% CI : 10.6–24.8, P < 0.001]). Conclusions The addition of a dexmedetomidine infusion prior to our propofol MRI sedation protocol resulted in fewer sedation‐related adverse events, particularly upper airway obstruction. Further studies are needed to evaluate the potential for a reduction on adverse events with this drug combination.