A comparison of the use of propofol alone and propofol with midazolam for pediatric magnetic resonance imaging sedation - a retrospective cohort study.
BACKGROUND
Pediatric MRI sedation performed by a variety of specialists such as sedationists and anesthesiologists commonly uses propofol, which has similar effects to an ideal sedative agent for maintaining deep sedation. However, when propofol is used, adverse airway events are relatively more common than when using other sedative agents. The concomitant administration of midazolam and propofol can reduce the dose of propofol needed for adequate sedation and might also reduce the frequency of airway obstruction without affecting the patient's recovery profile.


METHODS
We reviewed the our hospital records of all pediatric MRI sedation patients aged 3 to 16 years who were sedated with either propofol alone or propofol with midazolam between December 2013 and June 2016.


RESULTS
Eight hundred ninety-seven pediatric MRI sedation patients were included (n = 897). The frequency of airway intervention was 25/356 (7.0%) in Group P and 15/541 (2.8%) in Group PM (difference in proportions: 4.2%; 95% CI: 1.4-7.6%; p = 0.002). The mean (SD) time to awake was longer in Group PM compared to Group P [21.2 (5.6) minutes vs. 23.0 (7.1) minutes; mean difference, 1.8 min; 95% CI, 0.9-2.9; p < 0.001]. The mean (SD) time to discharge was longer in Group PM compared to Group P [34.5 (6.9) minutes vs. 38.6 (9.4) minutes; mean difference, 4.0 min; 95% CI, 3.0-5.1; p < 0.001].


CONCLUSIONS
The administration of a small dose of midazolam during pediatric MRI sedation using propofol can reduce the frequency of airway complications without prolonging the clinically significant recovery profile.
['Kang|RyungA|R|', 'Shin|Young Hee|YH|', 'Gil|Nam-Su|NS|', 'Kim|Ki Yoon|KY|', 'Yeo|Hyean|H|', 'Jeong|Ji Seon|JS|http://orcid.org/0000-0001-5396-1030']
D000293:Adolescent D000762:Anesthesia Recovery Period D002648:Child D002675:Child, Preschool D015331:Cohort Studies D004359:Drug Therapy, Combination D005260:Female D006801:Humans D006993:Hypnotics and Sedatives D007431:Intraoperative Complications D008279:Magnetic Resonance Imaging D008297:Male D008874:Midazolam D015742:Propofol D012189:Retrospective Studies
Propofol Midazolam Magnetic resonance imaging (MRI) Pediatric sedation