Propofol total intravenous anesthesia for MRI in children
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Published on: July 30, 2009
Andrew G Usher1, Ramona A Kearney, Ban C H Tsui
1Department of Anesthesiology and Pain Medicine, University of Alberta Hospital, Edmonton, Alberta T6G 2B7, Canada. ausher@ualberta.ca
Insights
Propofol total intravenous anesthesia safely maintains airway patency in children undergoing MRI. This method ensures rapid recovery with minimal adverse events, making it suitable for pediatric patients.
Area of Science:
- Pediatric Anesthesiology
- Medical Imaging Safety
- Airway Management
Background:
- Assessing airway patency and adverse events in 100 children undergoing propofol total intravenous anesthesia (TIVA) for MRI.
- Focus on spontaneous ventilation and oxygenation via nasal prongs.
Purpose of the Study:
- Evaluate clinical signs of airway patency during propofol TIVA in pediatric MRI.
- Determine airway intervention needs and adverse event rates.
- Assess recovery times and propofol dosage.
Main Methods:
- Clinical assessment of airway patency with stepwise interventions.
- Recording of propofol requirements, vital signs, procedure times, and adverse events.
- Analysis of respiratory rates and movement incidence.
Main Results:
- 93% of children maintained airway patency with a shoulder roll alone; minimal interventions were needed.
- Mean propofol induction dose: 3.9 mg/kg; infusion rate: 193 µg/kg/min.
- No respiratory or cardiovascular complications observed (0-3% risk); average discharge time: 44 minutes.
Conclusions:
- Propofol TIVA effectively preserves upper airway patency in children during MRI.
- The anesthetic regimen facilitates rapid recovery and a low incidence of complications.
- This approach is a safe and effective anesthetic option for pediatric MRI.
Background:
The aim of this study was to assess clinical signs of airway patency, airway intervention requirements and adverse events in 100 children receiving propofol total intravenous anesthesia for magnetic resonance imaging, with spontaneous ventilation and oxygenation via nasal prongs.
Methods:
Airway patency was clinically assessed and stepwise interventions were performed until a satisfactory airway was achieved. Propofol requirements, vital signs, procedure times and adverse events were also recorded.
Results:
Ninety-three per cent of children had no signs of airway obstruction when positioned with a shoulder roll only, two required a chin lift, four required an oral airway and one required lateral positioning. The mean propofol induction dose was 3.9 mg.kg(-1) (range 1.8-6.4 mg.kg(-1)). The mean propofol infusion rate was 193 microg.kg(-1).min(-1) (range 150-250 microg.kg(-1).min(-1)). The initial and final mean respiratory rates were 26 and 23 b.min(-1) (P < 0.05). Movement was more likely at lower infusion rates (mean 175 microg.kg(-1).min(-1)). There were no respiratory or cardiovascular complications (calculated risk: 95% CI = 0-3%). The mean time from end of scan to discharge home was 44 min.
Conclusions:
This study demonstrates good preservation of upper airway patency and rapid recovery using general anesthetic doses of propofol in children.
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