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.