Titrated propofol induction vs. continuous infusion in children undergoing magnetic resonance imaging

Acta Anaesthesiol Scand. 2010 Apr;54(4):453-7. doi: 10.1111/j.1399-6576.2009.02169.x. Epub 2009 Nov 23.

Abstract

Background: Propofol is the popular intravenous (i.v.) anaesthetic for paediatric sedation because of its rapid onset and recovery. We compared the efficacy and safety of a single dose and conventional infusion of propofol for sedation in children who underwent magnetic resonance imaging (MRI).

Methods: This was a double-blind, randomized-controlled study. One hundred and sixty children were assigned to group I (single dose) or II (infusion). Sedation was induced with i.v. propofol 2 mg/kg, and supplemental doses of propofol 0.5 mg/kg were administered until adequate sedation was achieved. After the induction of sedation, we treated patients with a continuous infusion of normal saline at a rate of 0.3 ml/kg/h in group I and the same volume of propofol in group II. In case of inadequate sedation, additional propofol 0.5 mg/kg was administered and the infusion rate was increased by 0.05 ml/kg/h. Induction time, sedation time, recovery time, additional sedation and adverse events were recorded.

Results: Recovery time was significantly shorter in group I compared with group II [0 (0-3) vs. 1 (0-3), respectively, P<0.001]. Group I (single dose) had significantly more patients with recovery time 0 compared with group II (infusion) (65/80 vs. 36/80, respectively, P<0.001). Induction and sedation times were not significantly different between groups. There was no significant difference in the frequency of additional sedation and adverse events between groups.

Conclusion: A single dose of propofol without a continuous infusion can provide appropriate sedation in children undergoing MRI for <30 min.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anesthesia Recovery Period
  • Anesthetics, Intravenous* / administration & dosage
  • Anesthetics, Intravenous* / adverse effects
  • Blood Pressure / drug effects
  • Carbon Dioxide / blood
  • Child
  • Child, Preschool
  • Conscious Sedation / methods*
  • Double-Blind Method
  • Female
  • Heart Rate / drug effects
  • Humans
  • Infant
  • Infusions, Intravenous
  • Magnetic Resonance Imaging / methods*
  • Male
  • Oxygen / blood
  • Patient Satisfaction
  • Propofol* / administration & dosage
  • Propofol* / adverse effects
  • Respiratory Mechanics / drug effects
  • Sample Size

Substances

  • Anesthetics, Intravenous
  • Carbon Dioxide
  • Oxygen
  • Propofol