• Der Anaesthesist · Dec 1996

    Randomized Controlled Trial Comparative Study Clinical Trial

    [Intravenous sedation of spontaneously breathing infants and small children before magnetic resonance tomography. A comparison of propofol and methohexital].

    • P Kessler, Y Alemdag, M Hill, S Dietz, and J Vettermann.
    • Zentrum der Anästhesiologie und Wiederbelebung, Johann Wolfgang Goethe-Universität, Frankfurt am Main.
    • Anaesthesist. 1996 Dec 1; 45 (12): 1158-66.

    UnlabelledThe purpose of the present study was to compare two sedation regimens with either propofol (P) or methohexital (M) for elective magnetic resonance imaging (MRI) in children with respect to safety, side effects, recovery, and discharge time.MethodsAfter Institutional Review Board approval, 120 unpremedicated children with a mean age of 26.5 +/- 21.4 months (M) and 28.1 +/- 19.9 months (P) were randomly assigned to receive a hypnotic induction dose of either M or P. Supplemental bolus injections of M or P were administered to maintain adequate sedation. The following parameters were measured: heart rate, oxygen saturation by pulse oximetry (SpO2), respiratory rate, end-tidal CO2 (PetCO2), side effects, and recovery and discharge times.ResultsSpontaneous respiration was maintained in all patients, and ventilatory support was only necessary for 2 min in 1 M patient immediately after the induction dose. The mean loading and total doses for M were 2.3 +/- 0.7 and 6.1 +/- 3.3 mg/kg respectively, and for P 2.3 +/- 0.9 and 5.8 +/- 2.7 mg/kg. Following induction SpO2 < 90% occurred in 0.49% with M and in 0.64% with P (n.s.). Apnoe > 20s was observed in 2 children each after M and P (n.s.). The frequency of hypoventilation (PetCO2 > 48 mmHg) was 0.36% in the M group and 0.71% in the P group (n.s.). MRI sequences had to be repeated in 5% of the children in each group because of spontaneous movements. The heart rate fell significantly during MRI in both groups, while P children had lower frequencies than M children (P < 0.01). Recovery and discharge times were significantly shorter in the P group, at 0.8 min (0.08-4.8) and 2.2 min (0.2-15.0), compared to 1.5 min (0.3-28.5) and 3.5 min (0.6-40.0) in patients receiving P (P < 0.01). No patient required admission to the postanaesthesia care unit and all were free from nausea and vomiting.DiscussionIntravenous sedation with M or P using the reported technique is a safe regimen for children undergoing elective MRI. The fast recovery and discharge times seem to offer advantages over general anaesthesia with endotracheal intubation. The faster recovery and discharge of only a few minutes after P compared with M is without clinical relevance.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.