Deep sedation with propofol for children undergoing ambulatory magnetic resonance imaging of the brain: experience from a pediatric intensive care unit.

OBJECTIVES

Use of intravenous propofol sedation to facilitate completion of magnetic resonance imaging of the brain in children.

DESIGN

Retrospective, cross-sectional.

SETTING

A university-affiliated pediatric intensive care unit.

PATIENTS

A total of 115 children who received intravenous propofol to complete magnetic resonance imaging of the brain January 1 through December 31, 2001.

INTERVENTIONS

Intravenous propofol infusion.

MEASUREMENTS AND MAIN RESULTS

The mean age was 4.2 +/- 3.1 yrs, and there were 63 boys and 52 girls. Sixty-nine percent of patients belonged to ASA physical status class I, and 31% belonged to ASA class II. All studies were completed with satisfactory image quality. The total dose of propofol used to complete a magnetic resonance image of the brain was 4.3 +/- 1.7 mg/kg body weight. The mean duration of sedation induction was 4.5 +/- 3.5 mins. The mean time to recovery (from the end of the procedure) was 20 +/- 15 mins. The duration of the procedure averaged 39 +/- 20 mins, and the time to discharge from the hospital was 50 +/- 21 mins from the end of the procedure. No episodes of hypoxia, apnea, or a need for artificial airway were noted. Systolic blood pressure decreased 10% +/- 13%, but none of the patients met the criteria for hypotension. A telephone call the next day to the family did not reveal any delayed complications.

CONCLUSIONS

Propofol can safely facilitate ambulatory magnetic resonance imaging of the brain in children, and it is associated with brief induction, recovery, and discharge times from the hospital. A drop in blood pressure, although mild and transient, does occur. Therefore, appropriate monitoring and preparedness for cardiorespiratory support are essential.