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Procedural sedation in children for magnetic resonance imaging--comparison between ketamine diazepam combination with

A A Maruf1, M D Hossain, M Ahmed

  • 1Department of Anaesthesia and Intensive Care, CMH, Dhaka, Bangladesh.

Mymensingh Medical Journal : MMJ
|January 5, 2010
PubMed

Insights

For pediatric MRI sedation, ketamine and diazepam offer a safe and effective alternative to midazolam and fentanyl. This combination is significantly more cost-effective, making it a crucial consideration for healthcare in regions like Bangladesh.

Area of Science:

  • Anesthesiology
  • Pediatric Imaging
  • Pharmacology

Background:

  • Pediatric sedation for Magnetic Resonance Imaging (MRI) requires careful consideration due to physiological differences from adults.
  • Anesthesiologist-administered sedation is essential for pediatric MRI procedures.
  • Evaluating different sedative agents is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

  • To compare the efficacy, safety, tolerability, and cost-effectiveness of ketamine-diazepam versus midazolam-fentanyl for pediatric MRI sedation.
  • To assess the suitability of these sedation regimens in a pediatric population aged 1-10 years.

Main Methods:

  • A randomized study involving 120 pediatric patients (ASA physical status I and II) undergoing MRI.
  • Group A received intravenous ketamine (1.5 mg/kg) and diazepam (0.1 mg/kg).
  • Group B received intravenous midazolam (0.05 mg/kg) and fentanyl (1 µg/kg).

Main Results:

  • Both regimens provided satisfactory sedation for MRI with transient, minor side effects.
  • Hemodynamic and respiratory parameters remained stable in both groups.
  • Group A had a statistically significant longer mean recovery time (p<0.05) but was five times more cost-effective than Group B.

Conclusions:

  • Ketamine-diazepam and midazolam-fentanyl combinations are safe and effective for pediatric MRI sedation.
  • The ketamine-diazepam combination is significantly more cost-effective, presenting a considerable advantage in resource-limited settings like Bangladesh.
  • Further research may explore optimizing recovery times for the ketamine-diazepam regimen.

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