title: Pediatric sedation in a community hospital-based outpatient MRI center.
abstract: OBJECTIVE
  Although the demand for pediatric MRI is increasing, it is uncommon to find sedation being offered at community hospital-based outpatient centers. We present our safety, efficacy, and outcome data at a community hospital-based outpatient imaging center.
  
  
  METHODS
  I.v. dexmedetomidine sedation was administered as a bolus of 3 μg/kg and maintained with a continuous infusion of 1 μg/kg/hr until imaging was complete. The dexmedetomidine bolus could be repeated up to two times, if needed. Quality assurance data were reviewed.
  
  
  RESULTS
  From April 2009 to July 2010, 279 children (mean age, 4.2 years; age range, 0.2-17.2 years) were sedated. All received a first bolus, 46 required a second dose, and two received a third. The average time to achieve sedation was 7.8 minutes (SD, ± 3.8 minutes). Total duration of imaging (82% brain MRI) averaged 38.1 minutes (range, 8.0-126.0 minutes). On average, discharge criteria were met within 21.3 minutes of arrival in recovery room (± 17.8 minutes). The heart rate and blood pressure deviated from baseline by more than 20% in 5% and 33% of the patients, respectively. No pharmacologic therapy was administered to treat the hemodynamic variability. There were no adverse respiratory events. All imaging studies were successfully completed.
  
  
  CONCLUSIONS
  Dexmedetomidine offers an option for pediatric sedation for MRI at community hospital-based outpatient settings. It preserves respiration but elicits deviations in blood pressure and heart rate that have not required pharmacologic intervention. Dexmedetomidine offers a safe, effective, and efficient agent for sedation for children undergoing MRI in an outpatient setting.
authors.affiliation: Department of Anesthesiology, Children's Hospital Boston, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA. keira.mason@childrens.harvard.edu
authors.forename: Keira P
authors.initials: KP
authors.lastname: Mason
authors.forename: Paulette J
authors.initials: PJ
authors.lastname: Fontaine
authors.forename: Fay
authors.initials: F
authors.lastname: Robinson
authors.forename: Steven
authors.initials: S
authors.lastname: Zgleszewski
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods*; D020927:Dexmedetomidine / Q000008:administration & dosage*; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D010044:Outpatient Clinics, Hospital
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine