Abstract
Introduction: Magnetic resonance imaging is a highly precise diagnostic modality for the diagnosis of congenital as well as acquired pathologies in pediatric age group. The advantages of MRI include its high sensitivity and specificity for the diagnosis of various intracranial pathologies. Moreover, its devoid of any radiation exposure. One of the prerequisites for MRI imaging is that patient needs to remain still during the procedure otherwise movement artefact will be produced making the interpretation difficult. Dexmedetomidine and propofol can be used as sedatives in pediatric patients undergoing MRI. We conducted this comparative study to analyses the utility of Dexmedetomidine and propofol as sedating agent in pediatric patients undergoing MRI imaging.
Materials and Methods: This was a comparative study in which pediatric patients between 2 - 12 years and undergoing MRI imaging were included on the basis of a predefined inclusion and exclusion criteria. The study was conducted in anesthesiology department of a tertiary care medical college located in an urban area. Total 60 pediatric patients undergoing MRI and who required sedation were included int this study. Out of 60 cases 30 patients (Group A) were given Dexmedetomidine 1 μg/kg initial dose followed by infusion of 0.5 μg/kg/hr (if needed). Remaining 30 patients (Group B) patients received propofol 3 mg/kg initial dose followed by infusion of 100 μg/kg/min (if needed). Demographic dataof patients in both the groups was recorded and compared. Onset of sedation time, recovery time, duration of sedation and ability to reduce motion resulting into good quality MRI and any adverse event were compared. For statistical analysis SSPE 21.0 software was used and p value less than0.05 was taken as statistically significant.
Results: Out of 60 studied cases there were 42 males and 18 females with a M:F ratio of1:0.42. Mean age of the patients in group A and group B was 6.2 +/- 2.12 and 5.9 +/- 1.98 years. The age groups were found to be comparable (P>0.05). Mean onset of sedation time in group A and group B was 10.2 +/- 3.12and 3.82 +/- 1.90 minutes (P<0.05). Mean recovery time in group A and B was found to be 24 +/-14.24 and 14 +/- 3.92 (P<0.05). Mean time needed for MRI was 22 +/- 5.12 and 24 +/- 4.42 in group A and B respectively (P>0.05). Mean sedation time was found to be 42 +/- 12.22 and 44 +/-11.82 minutes in group A and B respectively (P>0.05). The incidence of pediatric anesthesia mergence delirium was found to be 2 and 3 patients in group A and B respectively.
Conclusion: Dexmedetomidine was found have late onset of sedation time and prolonged recovery time as compared to propofol in children requiring sedation for MRI. Mean sedation time was found to be comparable. The adverse events were more common with propofol as compared to dexmedetomidine.
Keywords: Dexmedetomidine, propofol, sedation, Magnetic resonance imaging.
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Corresponding Author
Dr Jayesh Ingle
Assistant Professor Department of Anesthesiology Dr.Panjabrao Deshmukh Memorial Medical College, Amravati (MS)- India
DOI: https://dx.doi.org/10.18535/jmscr/v7i5.49
