Efficasy of different anesthetics for achieving deep sedation during magnetic resonance imaging in children: Anesthetics for a deep sedation during magnetic resonance imaging

Introduction: During magnetic resonance imaging (MRI) in children, safe, fast and effective anesthetics should be chosen for achieving deep sedation. Until now, no single anesthetic had this qualities, and only with a combination of different anesthetics the desired level of sedation could be obtained. Methods: In this prospective study 90 children that were scheduled for MRI, ages 6 month to 7 years ASA status I-II, were investigated. According to the anesthetic that was used for deep sedation, patients were divided into three groups: group 1 (ketamine), group 2 (propofol) and group 3 (ketofol = ketamine + propofol). The following parameters were analyzed: gender, age and body weight, length of MRI, the time from the beginning of anesthetics administration to the start of MRI procedure, the number of repeated doses of anesthetics, the total amount of anesthetic per kilogram body weight, recovery time and side effects. Results: Analyzing the time from the start of administration of anesthetic until the conditions for performing MRI were achieved, a statistically significant shorter period of time in ketofol group (p <0.001) was observed in comparison with ketamine and propofol groups. The smallest number of repeated single bolus doses of anesthetics was in ketofol group with statistical significance of p ˂ 0.05 compared to ketamine and propofol groups. The shortest period of recovery after performing deep sedation was registered in propofol group (p <0.001). The total amount of anesthetic was significantly reduced in ketofol group (p <0.05) as compared to the single administration of drugs. Conclusion: Deep sedation during MRI in children is best achieved by simultaneous application of ketamine and propofol as compared to single administration, as it speeds up the start of MRI procedure, decrises the number of repeated doses and total amount of anesthetic, thus reducing side effects of anesthetics.