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Propofol anaesthesia in spontaneously breathing paediatric patients during magnetic resonance imaging
A Levati1, N Colombo, E M Arosio
1Niguarda Ca' Granda Hospital, Neuroanesthesia Department, Milan, Italy.
Insights
Propofol is safe for pediatric anesthesia during MRI scans. Higher doses were needed for smaller children, but adverse events were minimal, ensuring successful imaging.
Area of Science:
- Anesthesiology
- Pediatric Imaging
- Neurology
Background:
- Evaluating propofol for anesthesia in pediatric patients undergoing CNS MRI.
- Focus on spontaneously breathing children aged 2 weeks to 11 years.
Purpose of the Study:
- Assess the safety and efficacy of propofol for inducing and maintaining anesthesia.
- Determine dosage requirements based on patient weight.
Main Methods:
- Propofol anesthesia in spontaneously breathing children without intubation.
- Monitoring vital signs including pulse rate, blood pressure, ECG, EtCO2, and SpO2.
- Dividing patients into two groups based on body weight (<10 kg and >10 kg).
Main Results:
- Smaller children (<10 kg) required significantly higher propofol doses for induction and maintenance.
- Transient hypotension occurred in a small number of patients.
- Minimal and transient oxygen desaturation and elevated EtCO2 were observed in some patients, with no other significant side effects.
Conclusions:
- Propofol is a safe option for total intravenous anesthesia in pediatric patients during MRI.
- Successful completion of MRI studies with propofol anesthesia.
- Weight-based dosing adjustments are necessary for optimal propofol administration in children.
Background:
The aim of this study was to evaluate the use of propofol to induce and maintain anaesthesia in spontaneously breathing paediatric patients (age 2 weeks-11 years) during Magnetic Resonance Imaging (MRI) of the CNS.
Methods:
All patients were spontaneously breathing, without intubation, and received supplemental O2. Pulse rate, blood pressure (BP), electrocardiogram and EtCO2 were recorded in all patients, and in 38 subjects SpO2 was also monitored. Patients were divided in 2 groups according to their body weights: Group A (n = 34, bwt < or = 10 kg), and Group B (n = 48, bwt > 10 kg).
Results:
Dosage of propofol during the time of induction (from insertion of the i.v. cannula to positioning on the MRI table) was significantly higher in smaller children (Group A; 5.4 +/- 2.2 (SD) mg/kg) as compared to children with bwt above 10 kg (Group B; 3.7 +/- 1.6 mg/kg). Propofol dosage for maintenance of anaesthesia was significantly higher in smaller children (Group A: 10.1 +/- 5.7 vs Group B: 7.1 +/- 3.0 mgkg-1 h-1, P = 0.003). During the time of induction, transient episodes of reduced BP (< or = 20%) occurred in 6 patients in Group A and 2 patients in Group B. During anaesthesia in Group B there was 1 episode of oxygen desaturation (95%), and 3 episodes of short and mild increases of EtCO2(< or = 52 mmHg). No other side effects occurred in any patient. MRI studies were successfully completed, only 3 sequences (Group A) had to be restarted.
Conclusion:
Propofol can be safely used for total intravenous anaesthesia in children undergoing MRI.