title: Propofol sedation for longitudinal pediatric neuroimaging research.
abstract: There is disagreement about allowing propofol sedation for research magnetic resonance imaging/spectroscopy (MRI/MRS) in children. Our study is the first to provide relevant safety and efficacy data. With institutional approval, 108 research MRI/MRS procedures under propofol sedation were performed longitudinally on children at ages 3-4 years (N=59) and 6-7 years (N=49). Sedation parameters, physiological values, and outcome data were collected. Success rate for acquisition of satisfactory quality MRI/MRS during propofol sedation was compared with that in typically developing, age-matched sleeping children. Only 5 minor events (2 with need to insert an oral airway, 2 with premature termination of study, 1 with bradycardia not requiring treatment) and no major events occurred. These safety/efficacy data are equal to or better than previously reported with propofol for clinically indicated procedures. A high percentage of parents of children participating in MRI/MRS studies at 3-4 years of age returned with their child at 6-7 years of age, and longitudinal follow-up was not adversely impacted by their child's experience with sedation. The success rate of data acquisition was significantly higher during propofol sedation (98%) than during late-night sleep studies in typically developing children (30%-50%). We conclude that propofol sedation for research MRI/MRS is safe and effective when children of appropriate ASA class are selected, supplemental oxygen is delivered, and sedation and monitoring are done by an experienced anesthesiologist.
authors.affiliation: Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington 98195-6540, USA.
authors.forename: Laurie B
authors.initials: LB
authors.lastname: Amundsen
authors.forename: Alan A
authors.initials: AA
authors.lastname: Artru
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Dager
authors.forename: Dennis W W
authors.initials: DW
authors.lastname: Shaw
authors.forename: Seth
authors.initials: S
authors.lastname: Friedman
authors.forename: Bobbi
authors.initials: B
authors.lastname: Sparks
authors.forename: Geraldine
authors.initials: G
authors.lastname: Dawson
mesh_terms: D000375:Aging / Q000502:physiology; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis*; D015742:Propofol / Q000009:adverse effects; D011674:Pulse; D012129:Respiratory Function Tests
chemical_list: D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D015742:Propofol