1. Malviya S, Voepel-Lewis T, Eldevik OP, Rockwell DT,
Wong JH, Tait AR. Sedation and general anaesthesia in
children undergoing MRI and CT: Adverse events and
outcomes. Br J Anaesth 2000; 84: 743-8.
2. Hubbard AM, Markowitz RI, Kimmel B, Kroger M,
Bartko MB. Sedation for pediatric patients undergoing
CT and MRI. J ComputAssist Tomogr 1992;1 6: 3-6.
3. Peden CJ, Menon DK, Hall AS, Sargentoni J, Whitham
JG. Magnetic resonance for the anaesthetist.
Anaesthesia 1992; 47: 50817.
4. Frush DP, Bisset III GS. Sedation of children in
radiology: Time to wake up.AJR 1995; 165: 913-4.
5. Karlýk SJ, Heatherley T, Pavan F, Stein J, Lebrron F.
Patient anesthesia and monitoring at 1.5 Tesla MRI
installation. Magn Reson Med 1988; 7: 210-21.
6. Bloomfield EL, Masaryk TJ, Caplin A, Obuchowski
NA, Schubert A, Hayden, Ebrahim ZY, Ruggieri PM,
Goske MJ, Ross JS. Intravenous sedation for MR
imaging of the brain and spine in children:
Pentobarbital versus propofol. Radiology 1993; 186:
93-7.
7. Vangerven M. Light anaesthesia with propofol for
paediatric MRI.Anaesthesia 1992; 47: 706-7.
8. Reinhold P. Propofol zur sedierung bei padiatrischen
Kernspintomographie- Untersuchungen [Propofol for
sedation in pediatric magnetic resonance imaging
investigations. J Klin Padiatr 1999; 211: 40-3.
9. Kessler P. Intravenose sedierung von spontanatmenden
Saulingen und Kleinkindern wahrend der
Magnetresonanztomographie. Ein Verleich zwischen
Propofol und Methohexital. Anaesthesist 1996; 45:
1158-66.
10. D'Agostino J, Terndrup TE. Chloralhydrate versus
midazolam for sedation of children for neuroimaging: a
randomized clinical trial. Pediatr Emerg Care 2000; 16:
1-4.
11. Mc CarverMay DG, Kang J, Aouthmany M, Elyon R,
Mowery JL, Slovis TL, Kauffmann R. Comparison of
chloral hydrate and midazolam for sedation of neonates
for neuroimaging studies. J Pediatr 1996; 128: 5736.
12. Schwengel D, Elwood T, Yaster M. Sedationfor
radiology and radiation therapy. In: Yaster M, Krane
EJ, Kaplan RP, Cote CJ, Lappe DG (eds). Pediatric Pain
Management and Sedation Handbook. St Louis:
Mosby-Year Book, 1997: 345-74.
13. Grounds RM, Lalor JM, Lumley J, Royston D, Morgan
M. Propofol infusion for sedation in the intensive care
unit: preliminary report. BMJ 1987; 294: 397-400.
14. Sneyd JR, Carr A, Byrom WD. Bilski AJT. A metaanalysis
of nausea and vomiting following
maintenance of anesthesia with propofol or inhalation
agents. Eur JAnaesthesiol 1998; 15: 43345.
15. Tomatýr E, Atalay H, Gürses E, Kaplan L, Gönüllü M.
Pediatrik manyetik rezonans görüntü
lemede propofol ile propofol-ketamin
kombinasyonunun karþýlaþtýrýlmasý. Anestezi Dergisi
2000; 8: 25-9.
16. Whitwam JG. The use of midazolam and flumazenil in
diagnostic and short surgical procedures. Acta
Anaesthesiol Scand Suppl. 1990; 92: 16-20.
17. Hartwig S, Roth B, Theisohn M. Clinical experience
with continuous intravenous sedation using
midazolam and fentanyl in the pediatric intensive care
unit. Eur J Pediatr 1991; 150: 784-8.
18. Ljugman G, Kreuger A, Andreasson S, Gordh T,
Sorensen S. Midazolam nasal spray reduces procedural
anxiety in children. Pediatrics 2000; 105 (1Pt1): 73-8.
19. Dundee JW, Halliday NJ, Harper KW, Midazolam: A
review of it's pharmacological properties and
therapeutic use. Drugs 1984; 28: 519-43.
Comparison of Propofol and Midazolam Plus Propofol Sedation for Magnetic Resonance İmaging in Children
Year 2002,
Volume: 3 Issue: 1, 13 - 17, 01.04.2002
Background and objective: The aim of this investigation was to study the effects of propofol and midazolam followed by propofol on children who had epilepsy and mental retardation, and could not be sufficiently sedated with orally administered chloral hydrate and cardiac cocktail for Magnetic Resonance Imaging. Methods: We have compared the sedation levels using the Ramsay Sedation Score maintained by the infusion of either propofol alone or followed by intramuscular administration of midazolam in 23 neurologically debilitated children aged 4-10 years undergoing Magnetic Resonance Imaging. The patients received a slow intravenous bolus injectionof2 mgkg-1 propofol followed by continuous infusion, with(n=11) orwithout (n=12) midazolam (0.2 mg kg-1) sedation given intramuscularly 15 minutes before the Magnetic Resonance Imaging._Mann Whitney U, Chi square and Fisher's exact tests were used for the statistical analysis testing, p< 0.05 were considered to have statistical significance. Results: Sedation level was higher in midazolam plus propofol group than propofol group immediately before intravenous cannulation, and during Magnetic Resonance Imaging (p = 0.002; p = 0.001 respectively). In both groups, the respiratory rate decreased significantly following the injection of propofol (p= 0.025 and p= 0.021). Patients in the propofol group recovered rapidly. At the end of the first hour, the recovery scores of both groups were similar. In the dose scheme we have used, propofol produced sedation during Magnetic Resonance Imaging. Conclusions: In mentally retarded children, intramuscular midazolam injection followed by propofol resulted in better cooperation and sedation.
1. Malviya S, Voepel-Lewis T, Eldevik OP, Rockwell DT,
Wong JH, Tait AR. Sedation and general anaesthesia in
children undergoing MRI and CT: Adverse events and
outcomes. Br J Anaesth 2000; 84: 743-8.
2. Hubbard AM, Markowitz RI, Kimmel B, Kroger M,
Bartko MB. Sedation for pediatric patients undergoing
CT and MRI. J ComputAssist Tomogr 1992;1 6: 3-6.
3. Peden CJ, Menon DK, Hall AS, Sargentoni J, Whitham
JG. Magnetic resonance for the anaesthetist.
Anaesthesia 1992; 47: 50817.
4. Frush DP, Bisset III GS. Sedation of children in
radiology: Time to wake up.AJR 1995; 165: 913-4.
5. Karlýk SJ, Heatherley T, Pavan F, Stein J, Lebrron F.
Patient anesthesia and monitoring at 1.5 Tesla MRI
installation. Magn Reson Med 1988; 7: 210-21.
6. Bloomfield EL, Masaryk TJ, Caplin A, Obuchowski
NA, Schubert A, Hayden, Ebrahim ZY, Ruggieri PM,
Goske MJ, Ross JS. Intravenous sedation for MR
imaging of the brain and spine in children:
Pentobarbital versus propofol. Radiology 1993; 186:
93-7.
7. Vangerven M. Light anaesthesia with propofol for
paediatric MRI.Anaesthesia 1992; 47: 706-7.
8. Reinhold P. Propofol zur sedierung bei padiatrischen
Kernspintomographie- Untersuchungen [Propofol for
sedation in pediatric magnetic resonance imaging
investigations. J Klin Padiatr 1999; 211: 40-3.
9. Kessler P. Intravenose sedierung von spontanatmenden
Saulingen und Kleinkindern wahrend der
Magnetresonanztomographie. Ein Verleich zwischen
Propofol und Methohexital. Anaesthesist 1996; 45:
1158-66.
10. D'Agostino J, Terndrup TE. Chloralhydrate versus
midazolam for sedation of children for neuroimaging: a
randomized clinical trial. Pediatr Emerg Care 2000; 16:
1-4.
11. Mc CarverMay DG, Kang J, Aouthmany M, Elyon R,
Mowery JL, Slovis TL, Kauffmann R. Comparison of
chloral hydrate and midazolam for sedation of neonates
for neuroimaging studies. J Pediatr 1996; 128: 5736.
12. Schwengel D, Elwood T, Yaster M. Sedationfor
radiology and radiation therapy. In: Yaster M, Krane
EJ, Kaplan RP, Cote CJ, Lappe DG (eds). Pediatric Pain
Management and Sedation Handbook. St Louis:
Mosby-Year Book, 1997: 345-74.
13. Grounds RM, Lalor JM, Lumley J, Royston D, Morgan
M. Propofol infusion for sedation in the intensive care
unit: preliminary report. BMJ 1987; 294: 397-400.
14. Sneyd JR, Carr A, Byrom WD. Bilski AJT. A metaanalysis
of nausea and vomiting following
maintenance of anesthesia with propofol or inhalation
agents. Eur JAnaesthesiol 1998; 15: 43345.
15. Tomatýr E, Atalay H, Gürses E, Kaplan L, Gönüllü M.
Pediatrik manyetik rezonans görüntü
lemede propofol ile propofol-ketamin
kombinasyonunun karþýlaþtýrýlmasý. Anestezi Dergisi
2000; 8: 25-9.
16. Whitwam JG. The use of midazolam and flumazenil in
diagnostic and short surgical procedures. Acta
Anaesthesiol Scand Suppl. 1990; 92: 16-20.
17. Hartwig S, Roth B, Theisohn M. Clinical experience
with continuous intravenous sedation using
midazolam and fentanyl in the pediatric intensive care
unit. Eur J Pediatr 1991; 150: 784-8.
18. Ljugman G, Kreuger A, Andreasson S, Gordh T,
Sorensen S. Midazolam nasal spray reduces procedural
anxiety in children. Pediatrics 2000; 105 (1Pt1): 73-8.
19. Dundee JW, Halliday NJ, Harper KW, Midazolam: A
review of it's pharmacological properties and
therapeutic use. Drugs 1984; 28: 519-43.
Kurt N, Ertürk Ö, Oral H (April 1, 2002) Comparison of Propofol and Midazolam Plus Propofol Sedation for Magnetic Resonance İmaging in Children. Meandros Medical And Dental Journal 3 1 13–17.