title: Propofol-remifentanil or sevoflurane for children undergoing magnetic resonance imaging? A randomised study.
abstract: BACKGROUND
  Magnetic resonance imaging (MRI) of children is generally performed under sedation or with general anaesthesia (GA), but the ideal regimen has not been found. The aim of this study was to see if propofol-remifentanil would be a suitable alternative for the maintenance of anaesthesia in this category of patients.
  
  
  METHODS
  Children aged 1-10 years, American Society of Anesthesiologists physical status 1-2 were included. After induction with thiopental or sevoflurane, the children were randomised to maintenance of anaesthesia with an infusion of propofol and remifentanil (group PR) (56 μg/kg/min of propofol and 0.06 μg/kg/min of remifentanil) or with sevoflurane 1.3 MAC (group S). A binasal catheter was placed in group PR and a laryngeal mask airway in group S. The children breathed spontaneously. The Paediatric Anaesthesia Emergence Delirium (PAED) score (primary end point), the number of movements during MRI, and the length of stay in the recovery room (secondary endpoints) were recorded.
  
  
  RESULTS
  Sixty children were included in each group. A lower level of emergence delirium (measured as a lower PAED score) was found in group PR compared with group S, and the children in group PR were discharged earlier from the recovery room than the children in group S. However, 15 children in group PR vs. 0 in group S moved during the scan (P < 0.001).
  
  
  CONCLUSIONS
  The PR infusion ensured a satisfactory stay in the recovery room, but additional boluses were necessary during the MRI. Sevoflurane was reliable during the MRI, but emergence delirium was a concern.
authors.affiliation: Department of Anaesthesiology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark. niels.anker.pedersen@regionh.dk
authors.forename: N A
authors.initials: NA
authors.lastname: Pedersen
authors.forename: A G
authors.initials: AG
authors.lastname: Jensen
authors.forename: L
authors.initials: L
authors.lastname: Kilmose
authors.forename: K S
authors.initials: KS
authors.lastname: Olsen
mesh_terms: D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation; D002648:Child; D002675:Child, Preschool; D003693:Delirium / Q000139:chemically induced / Q000453:epidemiology; D004311:Double-Blind Method; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008738:Methyl Ethers; D008991:Monitoring, Physiologic; D009068:Movement / Q000187:drug effects; D017060:Patient Satisfaction; D010880:Piperidines; D015742:Propofol; D000077208:Remifentanil; D018401:Sample Size; D000077149:Sevoflurane; D016896:Treatment Outcome
chemical_list: D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D015742:Propofol