[Premedication and risks in computed tomography of newborn and infant children]

Area of Science:

• Pediatric Radiology
• Pharmacology
• Neuroimaging

Background:

• Computed tomography (CT) scans in neonates and infants necessitate sedation for immobilization.
• Sedative-hypnotic drugs carry significant risks, particularly in pediatric patients with central nervous system disorders.
• Previous CT premedication in a neonate resulted in respiratory arrest, highlighting procedural risks.

Observation:

• A study compared oral and intramuscular promazine for CT head scans in 146 infants and neonates.
• Oral promazine achieved a 96% successful sedation rate with no complications in 57 patients (5.2 mg/kg, 90 min prior).
• Intramuscular promazine in 89 patients (2.3 mg/kg, 45 min prior) had a 92% adequate sedation rate but a 7.9% complication rate.

Findings:

• Oral promazine demonstrated superior safety and efficacy compared to intramuscular administration for pediatric CT sedation.
• Oral promazine resulted in a higher success rate (96%) and zero complications versus intramuscular promazine (92% success, 7.9% complications).
• Adequate sedation was achieved in 93.8% of all patients receiving promazine.

Implications:

• Oral promazine is a highly effective and safe sedation option for pediatric CT investigations, especially in neuropediatrics.
• The method offers advantages such as fast recovery and electroencephalogram (EEG) compatibility, crucial for outpatient neuroimaging.
• This approach can reduce the risks associated with CT-scanning in vulnerable young patients.