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American Academy of Pediatrics
Research Articles

Comparison of Dexmedetomidine With Pentobarbital for Pediatric MRI Sedation

Getachew Teshome, Kiran Belani, Janet L. Braun, Diane R. Constantine, Rajender K. Gattu and Richard Lichenstein
Hospital Pediatrics November 2014, 4 (6) 360-365; DOI: https://doi.org/10.1542/hpeds.2013-0111
Getachew Teshome
1Division of Emergency Medicine, Department of Pediatrics
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Kiran Belani
2University of Maryland School of Medicine, Baltimore, Maryland
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Janet L. Braun
3Department of Radiology
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Diane R. Constantine
3Department of Radiology
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Rajender K. Gattu
1Division of Emergency Medicine, Department of Pediatrics
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Richard Lichenstein
1Division of Emergency Medicine, Department of Pediatrics
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Abstract

Background and Objective: Intravenous pentobarbital has been used in the past to sedate pediatric patients in preparation for MRI; however, the drug has unpredictable sedation time. Dexmedetomidine, because of its short half-life, is gaining popularity for pediatric MRI sedation in settings where the use of propofol is restricted for nonanesthesiologists. The objective was to compare induction time, recovery time, total sedation time, sedation failure rate, and adverse outcomes of patients sedated with pentobarbital and dexmedetomidine in preparation for pediatric MRI.

Methods: We reviewed a sedation database that contains clinical data for all children undergoing MRI studies while sedated with pentobarbital or dexmedetomidine between May 15, 2008, and October 30, 2010.

Results: During the study period, 281 sedations were induced in preparation for MRI (160 with pentobarbital, and 121 with dexmedetomidine). The 2 groups were comparable with regard to age, weight, gender, and American Society of Anesthesiologists status. The dexmedetomidine group had a significantly shorter recovery time (39 ± 21 vs 49 ± 27 minutes [P = .002]) and total sedation time (107 ± 28 vs 157 ± 44 minutes [P = .0001]). Induction time was similar between the groups. The adverse event rate for the study population was 3%.

Conclusions: Dexmedetomidine and pentobarbital can both be used successfully for MRI sedation in children. However, dexmedetomidine had a significantly shorter recovery time and total sedation time in our population.

  • sedation
  • MRI
  • pentobarbital
  • dexmedetomidine
  • Abbreviations:
    ASA
    American Society of Anesthesiologists
    CT
    computerized tomography
    RSS
    Ramsay Sedation Scale
    • Copyright © 2014 by the American Academy of Pediatrics
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    Hospital Pediatrics: 4 (6)
    Hospital Pediatrics
    Vol. 4, Issue 6
    1 Nov 2014
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    Comparison of Dexmedetomidine With Pentobarbital for Pediatric MRI Sedation
    Getachew Teshome, Kiran Belani, Janet L. Braun, Diane R. Constantine, Rajender K. Gattu, Richard Lichenstein
    Hospital Pediatrics Nov 2014, 4 (6) 360-365; DOI: 10.1542/hpeds.2013-0111

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    Comparison of Dexmedetomidine With Pentobarbital for Pediatric MRI Sedation
    Getachew Teshome, Kiran Belani, Janet L. Braun, Diane R. Constantine, Rajender K. Gattu, Richard Lichenstein
    Hospital Pediatrics Nov 2014, 4 (6) 360-365; DOI: 10.1542/hpeds.2013-0111
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