A Comparison of the Sedative, Hemodynamic, and Respiratory Effects of Dexmedetomidine and Propofol in Children Undergoing Magnetic Resonance Imaging

We compared the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging procedures. Sixty children were randomly distributed into two groups: The dexmedetomidine (D) group received 1 &mgr;g/kg initial dose followed by continuous infusion of 0.5 &mgr;g · kg−1 · h−1 and a propofol group (P) received 3 mg/kg initial dose followed by a continuous infusion of 100 &mgr;g · kg−1 · min−1. Inadequate sedation was defined as difficulty in completing the procedure because of the child's movement during magnetic resonance imaging. Mean arterial pressure (MAP), heart rate, peripheral oxygen saturation, and respiratory rate (RR) were recorded during the study. The onset of sedation, recovery, and discharge time were significantly shorter in group P than in group D. MAP, heart rate, and RR decreased during sedation from the baseline values in both groups. MAP and RR were significantly lower in group P than in group D during sedation. Desaturation was observed in four children of group P. Dexmedetomidine and propofol provided adequate sedation in most of the children. We conclude that although propofol provided faster anesthetic induction and recovery times, it caused hypotension and desaturation. Thus, dexmedetomidine could be an alternative reliable sedative drug to propofol in selected patients.

[1]  J. Berkenbosch,et al.  Additional Experience with Dexmedetomidine in Pediatric Patients , 2003, Southern medical journal.

[2]  J. Shayevitz,et al.  Deep sedation with propofol for children undergoing ambulatory magnetic resonance imaging of the brain: Experience from a pediatric intensive care unit , 2003, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[3]  Judith E. Hall,et al.  Sedative, Amnestic, and Analgesic Properties of Small-Dose Dexmedetomidine Infusions , 2000, Anesthesia and analgesia.

[4]  M. Sagy,et al.  Pediatric sedation for procedures titrated to a desired degree of immobility results in unpredictable depth of sedation. , 2001, Pediatric emergency care.

[5]  D. Bluemke,et al.  Sedation procedures in MR imaging: safety, effectiveness, and nursing effect on examinations. , 2000, Radiology.

[6]  M. Welte,et al.  Bispectral index-guided sedation with dexmedetomidine in intensive care: A prospective, randomized, double blind, placebo-controlled phase II study* , 2002, Critical care medicine.

[7]  N. Obuchowski,et al.  Intravenous sedation for MR imaging of the brain and spine in children: pentobarbital versus propofol. , 1993, Radiology.

[8]  C. Aun New i.v. agents. , 1999, British journal of anaesthesia.

[9]  Moore,et al.  Propofol and bradycardia: causation, frequency and severity. , 1997, British journal of anaesthesia.

[10]  M. Singer,et al.  Preliminary UK experience of dexmedetomidine, a novel agent for postoperative sedation in the intensive care unit , 1999, Anaesthesia.

[11]  Judith E. Hall,et al.  The Effects of Increasing Plasma Concentrations of Dexmedetomidine in Humans , 2000, Anesthesiology.

[12]  B. Tsui,et al.  Propofol total intravenous anesthesia for MRI in children , 2005, Paediatric anaesthesia.

[13]  Shobha Malviya,et al.  Sedation failures in children undergoing MRI and CT: is temperament a factor? , 2000 .

[14]  J. Berkenbosch,et al.  Initial experience with dexmedetomidine in paediatric‐aged patients , 2002, Paediatric anaesthesia.

[15]  G R Lawson,et al.  Sedation of children for magnetic resonance imaging , 2000 .

[16]  M. Shelly Dexmedetomidine: a real innovation or more of the same? , 2001, British journal of anaesthesia.

[17]  J. B. Dyck,et al.  The Dose of Propofol Required to Prevent Children from Moving during Magnetic Resonance Imaging , 1993, Anesthesiology.

[18]  R. Venn,et al.  Pharmacokinetics of dexmedetomidine infusions for sedation of postoperative patients requiring intensive care 2 , 2022 .

[19]  Jun Lu,et al.  The &agr;2-Adrenoceptor Agonist Dexmedetomidine Converges on an Endogenous Sleep-promoting Pathway to Exert Its Sedative Effects , 2003, Anesthesiology.

[20]  T. Voepel-Lewis,et al.  Sedation and general anaesthesia in children undergoing MRI and CT: adverse events and outcomes. , 2000, British journal of anaesthesia.

[21]  B. C. Bloor,et al.  Effects of intravenous dexmedetomidine in humans. I. Sedation, ventilation, and metabolic rate. , 1992, Anesthesiology.

[22]  R. Venn,et al.  Respiratory effects of dexmedetomidine in the surgical patient requiring intensive care , 2000, Critical care.

[23]  M. Koulu,et al.  Effects of dexmedetomidine, a selective α2‐adrenoceptor agonist, on hemodynamic control mechanisms , 1989, Clinical pharmacology and therapeutics.

[24]  A. But,et al.  Sedative, haemodynamic and respiratory effects of dexmedetomidine in children undergoing magnetic resonance imaging examination: preliminary results. , 2005, British journal of anaesthesia.