Intravenous sedation for MR imaging of the brain and spine in children: pentobarbital versus propofol.

The authors present a prospective study of single-agent pediatric sedation regimens for patients older than 2 years of age undergoing magnetic resonance (MR) imaging of the brain and spine. Thirty patients underwent MR imaging after intravenous administration of pentobarbital in successive boluses of 2.5 mg/kg to a maximum of 7.5 mg/kg. Thirty-one patients received an intravenous bolus followed by continuous infusion of propofol. The dosage schedule for propofol was 2 mg/kg (with supplemental 1 mg/kg boluses) followed by continuous infusion of 6 mg/kg per hour. There was no significant difference in the physiologic response to sedation between the two groups, although the magnitude of the drop in pulse was significantly greater in the group receiving propofol. Three patients receiving propofol experienced transient decreases in oxygen saturation, at variable times over the course of the procedure. However, patients recovered significantly faster from sedation with propofol. While propofol may represent a viable alternative to pentobarbital in selected patients, propofol requires constant physician supervision and meticulous technique.