Deep sedation with propofol for children undergoing ambulatory magnetic resonance imaging of the brain: Experience from a pediatric intensive care unit

Objectives: Use of intravenous propofol sedation to facilitate completion of magnetic resonance imaging of the brain in children. Design: Retrospective, cross-sectional. Setting: A university-affiliated pediatric intensive care unit. Patients: A total of 115 children who received intravenous propofol to complete magnetic resonance imaging of the brain January 1 through December 31, 2001. Interventions: Intravenous propofol infusion. Measurements and Main Results: The mean age was 4.2±3.1 yrs, and there were 63 boys and 52 girls. Sixty-nine percent of patients belonged to ASA physical status class I, and 31% belonged to ASA class II. All studies were completed with satisfactory image quality. The total dose of propofol used to complete a magnetic resonance image of the brain was 4.3±1.7 mg/kg body weight. The mean duration of sedation induction was 4.5 ±3.5 mins. The mean time to recovery (from the end of the procedure) was 20±15 mins. The duration of the procedure averaged 39±20 mins, and the time to discharge from the hospital was 50±21 mins from the end of the procedure. No episodes of hypoxia, apnea, or a need for artificial airway were noted. Systolic blood pressure decreased 10%±13%, but none of the patients met the criteria for hypotension. A telephone call the next day to the family did not reveal any delayed complications. Conclusions: Propofol can safely facilitate ambulatory magnetic resonance imaging of the brain in children, and it is associated with brief induction, recovery, and discharge times from the hospital. A drop in blood pressure, although mild and transient, does occur. Therefore, appropriate monitoring and preparedness for cardiorespiratory support are essential. (Pediatr Crit Care Med 2003; 4:454 -458).