Li Yuancui, Lei Rongzhu
Department of Anesthesiology, Shanxi Children's Hospital, Taiyuan, China.
Front Pediatr. 2025 Jan 6;12:1500277. doi: 10.3389/fped.2024.1500277. eCollection 2024.
Magnetic resonance imaging (MRI) is a crucial non-invasive diagnostic tool for pediatric diseases, requiring patients to remain still, often with the use of sedatives. Midazolam and dexmedetomidine are commonly used for sedation in children, but their combined effect needs further study. This study aims to evaluate the safety and effectiveness of combining intranasal dexmedetomidine (ID) with oral midazolam (OM) in children undergoing MRI, and assess its clinical feasibility.
A prospective, randomized controlled trial was conducted with 196 pediatric patients undergoing MRI from January 2022 to December 2023. Patients were randomly assigned to a control group (OM alone) or an observation group (OM + ID), with 98 cases each. Total sedation time, wake-up time, onset time, and adverse reactions were evaluated. Sedation effectiveness was assessed using the Ramsay Sedation Score.
The observation group had significantly longer total sedation time ( = 0.039) and higher one-time sedation success rate ( = 0.038) compared to the control group. The Ramsay score indicated better sedation effects in the observation group ( < 0.05). Adverse events were similar between groups and resolved with rest.
Combining ID with OM provides effective sedation for pediatric MRI, with an acceptable safety profile, supporting its use in clinical practice.
磁共振成像（MRI）是儿科疾病重要的非侵入性诊断工具，这需要患者保持静止，通常要使用镇静剂。咪达唑仑和右美托咪定常用于儿童镇静，但它们的联合效果需要进一步研究。本研究旨在评估鼻内给予右美托咪定（ID）联合口服咪达唑仑（OM）在接受MRI检查的儿童中的安全性和有效性，并评估其临床可行性。
对2022年1月至2023年12月期间196例接受MRI检查的儿科患者进行了一项前瞻性随机对照试验。患者被随机分为对照组（仅OM）或观察组（OM + ID），每组98例。评估总镇静时间、苏醒时间、起效时间和不良反应。使用Ramsay镇静评分评估镇静效果。
与对照组相比，观察组的总镇静时间显著更长（= 0.039），一次性镇静成功率更高（= 0.038）。Ramsay评分表明观察组的镇静效果更好（< 0.05）。两组间不良事件相似，经休息后缓解。
ID与OM联合使用可为儿科MRI提供有效的镇静作用，安全性可接受，支持其在临床实践中的应用。
