Study: Propofol is better for pediatric MRI sedation

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Propofol permits faster onset and recovery and comparable efficacy to a pentobarbital, midazolam and fentanyl regimen for sedation of children for MRI usage, according to the August issue of the Journal of the American Academy of Pediatrics.

Propofol and pentobarbital, alone or combined with other agents, are commonly used to induce deep sedation in children for MRI. So, the researchers compared these two agents as part of a randomized, controlled trial, along with recovery time of children after deep sedation with single-agent propofol with a pentobarbital-based regimen for MRI.

The study consisted of 60 patients between the ages 1 and 17 from a tertiary children’s hospital. The researchers randomly assigned patients to receive a loading dose of propofol followed by continuous intravenous infusion of propofol or to receive sequential doses of midazolam, pentobarbital and fentanyl until a modified Ramsay score of more than four was attained.

Of the groups similar in age, gender, race, status class and frequency of cognitive impairment, no sedation failure or significant adverse events were observed.

According to the results, propofol offered significantly shorter sedation induction time, recovery time, total sedation time and time to return to baseline functional status.

Researchers at the Department of Pediatrics at the University of Tennessee Health Science Center and LeBonheur Children's Medical Center; the Department of Preventive Medicine at the University of Tennessee Health Science Center; and the Division of Anesthesiology at St. Jude Children's Research Hospital; all located in Memphis, Tenn., participated in the study.