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[Intramuscular methohexital. A simple and reliable means of sedation for cerebral computed tomography in children]
J P Schoch1, R Robert, R Ramboatiana
1Département d'anesthésie-réanimation, Centre hospitalier général de Montbeliard.
Insights
Intramuscular methohexital is a reliable sedation method for pediatric CT scans, achieving immobility quickly with minimal adverse events. Ketamine may be needed in some cases, particularly for overweight children.
Area of Science:
- Pediatric Anesthesiology
- Radiology
Background:
- Sedation is crucial for pediatric CT scans.
- Ensuring patient immobility is vital for scan quality and safety.
Purpose of the Study:
- To evaluate the efficacy and safety of intramuscular methohexital for sedating children undergoing CT scans.
Main Methods:
- Retrospective study of 50 children (2 months-7 years).
- Oral premedication (diazepam, atropine) followed by intramuscular methohexital (10 mg/kg).
- ECG and spontaneous breathing monitoring.
Main Results:
- Adequate sedation achieved in most cases within 4.20 minutes.
- 96% of children moved during IV catheter insertion, without affecting puncture.
- 33% required additional ketamine (1-2 mg/kg), especially overweight children.
- Average sleep duration: 35 minutes; CT scan time: 23.3 minutes.
- No cardiovascular/respiratory events, local reactions, or seizures.
Conclusions:
- Intramuscular methohexital is an effective and safe sedation method for pediatric CT scans.
- Dose adjustment may be necessary for overweight children.
- The method facilitates successful imaging while ensuring patient safety.
Abstract:
Intramuscular methohexital sedation was retained as an easy and reliable method to sedate children for a C.T. scan. In this retrospective study of 50 cases of children aged from 2 months to 7 years all the children were administrated an oral premedication (diazepam: 1 drop/kg and atropine: 0.02 mg.kg-1) one hour before the scanner examination. Once in the operating room, they were administrated 10 mg.kg-1 methohexital saline 2.5% solution, intramuscularly deep in the buttock. E.C.G. was the main monitoring. Spontaneous breathing was evidenced by means of a simple device. At the end of the scan, the child was taken care for in the recovery room. The methohexital dose provided adequate sedation in most cases. Once the injection was given, a motionless state was reached in 4.20 minutes. The insertion of an intravenous catheter induced movements in 96% cases, which did not interfere with the successful intravenous puncture. In 33% cases, 1 to 2 mg.kg-1 ketamine was necessary because of a failed attempt at obtaining the required state, or of an awakening due to iodized injection. Among those cases, half the children were overweight for their ages. In this situation an adjusting dose should be considered. On average, a child under the influence of the drug slept for 35 minutes and the required time for a C.T. scan is 23.3 minutes. Time in the recovery room is on average 20 minutes. There was no episode of cardiovascular or respiration failure, or local reaction at the injection site. There was also no episode of seizure.(ABSTRACT TRUNCATED AT 250 WORDS)