Get access

Propofol vs pentobarbital for sedation of children undergoing magnetic resonance imaging: results from the Pediatric Sedation Research Consortium

Authors

  • MICHAEL D. MALLORY MD MPH,

    1. Pediatric Emergency Medicine Associates/Pediatric Sedation Services, Children’s Healthcare of Atlanta at Scottish Rite Hospital, Atlanta, GA, USA
    Search for more papers by this author
  • AMY L. BAXTER MD,

    1. Pediatric Emergency Medicine Associates/Pediatric Sedation Services, Children’s Healthcare of Atlanta at Scottish Rite Hospital, Atlanta, GA, USA
    2. Associate Professor of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA
    Search for more papers by this author
  • SUSANNE I. KOST MD,

    1. Associate Professor of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA
    2. Department of Anesthesia, A. I. duPont Hospital for Children, Wilmington, DE, USA
    Search for more papers by this author
  • THE PEDIATRIC SEDATION RESEARCH CONSORTIUM


Michael D. Mallory, MD, MPH, 2133 Kodiak Dr, Atlanta, GA 30345, USA (email: Michael.Mallory@choa.org).

Summary

Background:  Pentobarbital and propofol are commonly used to sedate children undergoing magnetic resonance imaging (MRI). The Pediatric Sedation Research Consortium (PSRC) was created in 2003 to improve pediatric sedation process and outcomes.

Objective:  To use PSRC records to compare the effectiveness, efficiency and adverse events of propofol vs pentobarbital for sedation of children undergoing MRI.

Methods:  Pediatric Sedation Research Consortium records of children aged 6 months to 6 years who were primarily sedated with either i.v. pentobarbital or propofol were included. Participating PSRC investigators obtained institutional review board approval before data collection.

Results:  Of 11 846 sedations for MRI, 7079 met inclusion criteria (propofol: n = 5072; pentobarbital: n = 2007). Demographic details were similar between the two groups. Ideal sedation was produced in 96.45% of the pentobarbital group and in 96.8% of the propofol group (P = 0.478), but pentobarbital was more likely to result in poor sedation canceling the procedure (OR 5.88; CI 2.24, 15.40). Propofol resulted in physiologic changes more frequently than did pentobarbital (OR 5.69; CI 1.35, 23.97). Pentobarbital was associated with prolonged recovery (OR 16.82; CI 4.98, 56.8), unplanned admission (OR 5.60; CI 1.02, 30.82), vomiting (OR 36.76; CI 4.84, 279.2) and allergic complication (OR 9.15; CI 1.02, 82.34). The incidence of airway complications was not significantly different between the two. The median recovery time for patients receiving propofol was 30 min, whereas for pentobarbital it was 75 min (P < 0.001).

Conclusion:  Among institutions contributing data to the PSRC, it is found that propofol provides more efficient and effective sedation than pentobarbital for children undergoing MRI. Although apnea occurred with a greater frequency in patients who received propofol, the rate of apnea and airway complications for propofol was not statistically different from that seen in patients who received pentobarbital.

Ancillary