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Optimal sedative dose of propofol to start MRI in children with cerebral palsy.

Kim EJ, Jo YY, Kil HK - Korean J Anesthesiol (2011)

Bottom Line: The ED50 and ED95 for successful sedation with a UMSS ≥ 3 were 2.07 mg/kg (95% CI 1.69-2.56) and 2.69 mg/kg (95% CI 2.35-5.59).Respiratory events occurred in 5 patients and were resolved with neck extension, chin lift, or transient respiratory assistance with successful sedation.Low dose propofol can safely facilitate the initiation of MRI in children with CP.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Background: This study was designed to determine the optimal sedative dose of propofol to start brain magnetic resonance imaging (MRI) in children with cerebral palsy (CP).

Methods: Twenty children, aged 0.5-5 years, were administered propofol to achieve a University of Michigan Sedation Scale (UMSS) score ≥ 3 in the MRI room. The proper dose of propofol was determined using the up-and-down method.

Results: The ED50 and ED95 for successful sedation with a UMSS ≥ 3 were 2.07 mg/kg (95% CI 1.69-2.56) and 2.69 mg/kg (95% CI 2.35-5.59). Respiratory events occurred in 5 patients and were resolved with neck extension, chin lift, or transient respiratory assistance with successful sedation.

Conclusions: Low dose propofol can safely facilitate the initiation of MRI in children with CP.

No MeSH data available.


Related in: MedlinePlus

Responses of the 20 consecutive children for whom sedation for MRI scanning was attempted and the propofol concentration. Each patient's data are represented by a circle.
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Figure 1: Responses of the 20 consecutive children for whom sedation for MRI scanning was attempted and the propofol concentration. Each patient's data are represented by a circle.

Mentions: The sequence of successful and unsuccessful induction of deep sedation is shown in Fig. 1. The ED50 and ED95 for successful sedation with UMSS ≥3 were 2.07 mg/kg (95% CI 1.69-2.56) and 2.69 mg/kg (95% CI 2.35-5.59), respectively. Immediately after propofol injection, respiratory events (desaturation <95% and partial airway obstruction) occurred in five patients with successful sedation (SpO2 <95% in four and <85% in one), which were promptly resolved with a neck extension, chin lift, or transient respiratory assistance. No other adverse events such as hypotension, bradycardia, or arrhythmia were observed during the MRI examination. All scheduled MRI examinations were successfully completed within 30 minutes. In 10 children, additional propofol was administered. No one showed emergence agitation, abnormal behaviour, fever, or nausea and vomiting during recovery after sedation or in the first 24 h after discharge.


Optimal sedative dose of propofol to start MRI in children with cerebral palsy.

Kim EJ, Jo YY, Kil HK - Korean J Anesthesiol (2011)

Responses of the 20 consecutive children for whom sedation for MRI scanning was attempted and the propofol concentration. Each patient's data are represented by a circle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198182&req=5

Figure 1: Responses of the 20 consecutive children for whom sedation for MRI scanning was attempted and the propofol concentration. Each patient's data are represented by a circle.
Mentions: The sequence of successful and unsuccessful induction of deep sedation is shown in Fig. 1. The ED50 and ED95 for successful sedation with UMSS ≥3 were 2.07 mg/kg (95% CI 1.69-2.56) and 2.69 mg/kg (95% CI 2.35-5.59), respectively. Immediately after propofol injection, respiratory events (desaturation <95% and partial airway obstruction) occurred in five patients with successful sedation (SpO2 <95% in four and <85% in one), which were promptly resolved with a neck extension, chin lift, or transient respiratory assistance. No other adverse events such as hypotension, bradycardia, or arrhythmia were observed during the MRI examination. All scheduled MRI examinations were successfully completed within 30 minutes. In 10 children, additional propofol was administered. No one showed emergence agitation, abnormal behaviour, fever, or nausea and vomiting during recovery after sedation or in the first 24 h after discharge.

Bottom Line: The ED50 and ED95 for successful sedation with a UMSS ≥ 3 were 2.07 mg/kg (95% CI 1.69-2.56) and 2.69 mg/kg (95% CI 2.35-5.59).Respiratory events occurred in 5 patients and were resolved with neck extension, chin lift, or transient respiratory assistance with successful sedation.Low dose propofol can safely facilitate the initiation of MRI in children with CP.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Background: This study was designed to determine the optimal sedative dose of propofol to start brain magnetic resonance imaging (MRI) in children with cerebral palsy (CP).

Methods: Twenty children, aged 0.5-5 years, were administered propofol to achieve a University of Michigan Sedation Scale (UMSS) score ≥ 3 in the MRI room. The proper dose of propofol was determined using the up-and-down method.

Results: The ED50 and ED95 for successful sedation with a UMSS ≥ 3 were 2.07 mg/kg (95% CI 1.69-2.56) and 2.69 mg/kg (95% CI 2.35-5.59). Respiratory events occurred in 5 patients and were resolved with neck extension, chin lift, or transient respiratory assistance with successful sedation.

Conclusions: Low dose propofol can safely facilitate the initiation of MRI in children with CP.

No MeSH data available.


Related in: MedlinePlus