Dexmedetomidine Verses Propofol for Paediatric MRI Brain
Condition: Brain Diseases
MeSH terms: Brain Diseases
Study type: Interventional
Phase: Phase 4

Summary: 
      MRI though not painful requires deep sedation for children due to the loud noise created.
      With deep sedation comes respiratory depression so the interest in Dexmedetomidine. For
      standardization MRI brain was chosen and also for the fact that patients usually have history
      of convulsions where drugs like ketamine may not be a good option. Patients were recruited
      after ethics committee approval. After pre-medication with intranasal midazolam 0.2 mg/kg
      body weight, Intravenous access was established and then patients were divided in two groups.
      One group received intravenous propofol 2mg/Kg and infusion of 100mcg/per kg body weight per
      minute. The other group received intravenous bolus of Dexmedetomidine 1mcg/kg over 10 minutes
      and then a infusion of Dexmedetomidine 1mcg/kg/hour.

      Primary out come was to study the recovery time of patients sedated with Dexmedetomidine
      compared to patients sedated with propofol for paediatric MRI brain. Secondary outcome were
      analysed in terms of time for induction,procedural disruptions due to awakening and
      haemodynamic stability . Follow up was done on phone for any adverse events.
    

Detailed description: 
      Patients were evaluated on out patient department basis. On the day of MRI nil per oral
      status of 6 hours was confirmed and consent taken from the parent. In recovery room after
      recording of vitals, children were given intranasal midazolam 0.2mg/kg body weight. The
      intravenous line was secured after the child was sedated. Patients were then divided in two
      groups. In the MRI console, the dexmedetomidine group received intravenous dexmedetomidine
      1mcg/kg body weight over 10 minutes. An intravenous infusion of dexmedetomidine was then
      started at 1mcg/kg/hour.

      The propofol group received 2mg /kg of intravenous propofol and an infusion of
      100mcg/kg/minute.

      MRI monitoring included pulseoximetry, cardioscope, respiratory pattern and rate. Oxygen was
      delivered by nasal prongs. Primary outcome measured was the time for recovery.

      Secondary outcomes were number of awakening during procedure, haemodynamic stability,
      induction time and any adverse events.

      After MRI the children were observed in the recovery room and discharged after achieving
      'modified aldred score' of 10. Vitals and any adverse events were recorded during this phase.
    

Intervention name(s): Dexmedetomidine; propofol; Midazolam
Intervention type(s): Drug; Drug; Drug
Intervention description(s): intravenous dexmedetomidine 1 mcg per kg body weight over 10 minutes followed by infusion of dexmedetomidine at dose of 1 mcg per kg body weight per hour till end of procedure; intravenous propofol 2mg per kg body weight followed by infusion of propofol at a dose of 100 mcg per kg body weight per min till end of procedure; Intra nasal midazolam 0.2 mg per kg body weight before intravenous canulation
Other intervention name(s): Dexem; propoven; diprivan; Versed; Fulsed
Intervention MeSH terms: Midazolam; Dexmedetomidine; Propofol
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Anaesthesia; MRI; Brain