• RyungA Kang, Young Hee Shin, Nam-Su Gil, Ki Yoon Kim, Hyean Yeo, and Ji Seon Jeong.
• Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University school of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 06351, Korea.
• BMC Anesthesiol. 2017 Oct 11; 17 (1): 138.

BackgroundPediatric MRI sedation performed by a variety of specialists such as sedationists and anesthesiologists commonly uses propofol, which has similar effects to an ideal sedative agent for maintaining deep sedation. However, when propofol is used, adverse airway events are relatively more common than when using other sedative agents. The concomitant administration of midazolam and propofol can reduce the dose of propofol needed for adequate sedation and might also reduce the frequency of airway obstruction without affecting the patient's recovery profile.MethodsWe reviewed the our hospital records of all pediatric MRI sedation patients aged 3 to 16 years who were sedated with either propofol alone or propofol with midazolam between December 2013 and June 2016.ResultsEight hundred ninety-seven pediatric MRI sedation patients were included (n = 897). The frequency of airway intervention was 25/356 (7.0%) in Group P and 15/541 (2.8%) in Group PM (difference in proportions: 4.2%; 95% CI: 1.4-7.6%; p = 0.002). The mean (SD) time to awake was longer in Group PM compared to Group P [21.2 (5.6) minutes vs. 23.0 (7.1) minutes; mean difference, 1.8 min; 95% CI, 0.9-2.9; p < 0.001]. The mean (SD) time to discharge was longer in Group PM compared to Group P [34.5 (6.9) minutes vs. 38.6 (9.4) minutes; mean difference, 4.0 min; 95% CI, 3.0-5.1; p < 0.001].ConclusionsThe administration of a small dose of midazolam during pediatric MRI sedation using propofol can reduce the frequency of airway complications without prolonging the clinically significant recovery profile.

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