Propofol vs pentobarbital for sedation of children undergoing magnetic resonance imaging: results from the Pediatric Sedation Research Consortium

被引:48
作者
Mallory, Michael D. [1 ]
Baxter, Amy L. [1 ,2 ]
Kost, Susanne I. [2 ,3 ]
机构
[1] Childrens Healthcare Atlanta Scottish Rite Hosp, Pediat Sedat Serv, Atlanta, GA USA
[2] Thomas Jefferson Univ, Philadelphia, PA 19107 USA
[3] Alfred I DuPont Hosp Children, Dept Anesthesia, Wilmington, DE USA
关键词
propofol; pentobarbital; sedation; radiology; magnetic resonance imaging; DEPARTMENT PROCEDURAL SEDATION; CHLORAL HYDRATE; ANESTHESIA; EMERGENCY; MRI; INDUCTION; KETAMINE; INFANTS; SODIUM; BRAIN;
D O I
10.1111/j.1460-9592.2009.03023.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Pentobarbital and propofol are commonly used to sedate children undergoing magnetic resonance imaging (MRI). The Pediatric Sedation Research Consortium (PSRC) was created in 2003 to improve pediatric sedation process and outcomes. To use PSRC records to compare the effectiveness, efficiency and adverse events of propofol vs pentobarbital for sedation of children undergoing MRI. Pediatric Sedation Research Consortium records of children aged 6 months to 6 years who were primarily sedated with either i.v. pentobarbital or propofol were included. Participating PSRC investigators obtained institutional review board approval before data collection. Of 11 846 sedations for MRI, 7079 met inclusion criteria (propofol: n = 5072; pentobarbital: n = 2007). Demographic details were similar between the two groups. Ideal sedation was produced in 96.45% of the pentobarbital group and in 96.8% of the propofol group (P = 0.478), but pentobarbital was more likely to result in poor sedation canceling the procedure (OR 5.88; CI 2.24, 15.40). Propofol resulted in physiologic changes more frequently than did pentobarbital (OR 5.69; CI 1.35, 23.97). Pentobarbital was associated with prolonged recovery (OR 16.82; CI 4.98, 56.8), unplanned admission (OR 5.60; CI 1.02, 30.82), vomiting (OR 36.76; CI 4.84, 279.2) and allergic complication (OR 9.15; CI 1.02, 82.34). The incidence of airway complications was not significantly different between the two. The median recovery time for patients receiving propofol was 30 min, whereas for pentobarbital it was 75 min (P < 0.001). Among institutions contributing data to the PSRC, it is found that propofol provides more efficient and effective sedation than pentobarbital for children undergoing MRI. Although apnea occurred with a greater frequency in patients who received propofol, the rate of apnea and airway complications for propofol was not statistically different from that seen in patients who received pentobarbital.
引用
收藏
页码:601 / 611
页数:11
相关论文
共 32 条
[11]   Propofol in emergency medicine: Pushing the sedation frontier [J].
Green, SM ;
Krauss, B .
ANNALS OF EMERGENCY MEDICINE, 2003, 42 (06) :792-797
[12]   Initial experience with intravenous pentobarbital sedation for children undergoing MRI at a tertiary care pediatric hospital: the learning curve [J].
Greenberg, SB ;
Adams, RC ;
Aspinall, CL .
PEDIATRIC RADIOLOGY, 2000, 30 (10) :689-691
[13]   Propofol anesthesia in spontaneously breathing children undergoing magnetic resonance imaging: comparison of two propofol emulsions [J].
Gutmann, A ;
Pessenbacher, K ;
Gschanes, A ;
Eggenreich, U ;
Wargenau, M ;
Toller, W .
PEDIATRIC ANESTHESIA, 2006, 16 (03) :266-274
[14]  
Hasan Rashed A, 2003, Pediatr Crit Care Med, V4, P454, DOI 10.1097/01.PCC.0000090013.66899.33
[15]   A clinical trial of propofol vs midazolam for procedural sedation in a pediatric emergency department [J].
Havel, CJ ;
Strait, RT ;
Hennes, H .
ACADEMIC EMERGENCY MEDICINE, 1999, 6 (10) :989-997
[16]  
KAIN ZN, 1994, ANESTH ANALG, V79, P1102
[17]   Preparation, premedication, and surveillance [J].
Lazzaroni, M ;
Porro, CB .
ENDOSCOPY, 2005, 37 (02) :101-109
[18]  
LEBOVIC S, 1992, ANESTH ANALG, V74, P490
[19]   Propofol anaesthesia in spontaneously breathing paediatric patients during magnetic resonance imaging [J].
Levati, A ;
Colombo, N ;
Arosio, EM ;
Savoia, G ;
Tommasino, C ;
Scialfa, G ;
Boselli, L .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 1996, 40 (05) :561-565
[20]   Pentobarbital vs chloral hydrate for sedation of children undergoing MRI: efficacy and recovery characteristics [J].
Malviya, S ;
Voepel-Lewis, T ;
Tait, AR ;
Reynolds, PI ;
Gujar, SK ;
Gebarski, SS .
PEDIATRIC ANESTHESIA, 2004, 14 (07) :589-595