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Abstract

Background and aims: Propofol is an effective agent to provide sedation for children undergoing diagnostic imaging. Most regimens use propofol with a bolus induction dose followed by continuous infusion. We report the effectiveness of an intermittent bolus regimen for children undergoing MRI on an ambulatory basis. Aims: To establish the safety and efficacy of an intermittent low dose propofol regimen for children undergoing MRI. Methods: A retrospective chart review identified children who received this regimen from 2009–2012. The protocol includes comprehensive evaluation by a pediatric intensivist, premedication with midazolam 0.1 mg/kg, induction with propofol 1.5–2 mg/kg, followed by intermittent boluses of 1–1.5 mg/kg titrated to need. We report the induction time, sedation time, time to discharge, adverse events, need for additional agents, and failed sedation. Results: Data included 183 children, four were infants. Mean age was 4.8 years (SD 3.2), and body weight was 18.3 kg (SD 10). The mean induction dose was 2.1mg/kg (SD 0.5). The median induction time was 4 minutes (range 1–7 min.), sedation time 26 minutes (range 8–60), and time to discharge 14 minutes (range 5–45). Mean total dose of propofol was 2.7mg/kg (SD 1.1). 93 children (50.5%) completed the study with a single induction dose, while 15 (8.2%) required more than two doses. Sedation with a second agent was needed in 9 children (4.9%). Eight children (4.3%) needed airway manoeuvres and 27 (14.8%) experienced significant bradycardia. Three (1.6%) failed sedation. Conclusions: Intermittent dosing regimen of propofol was effective and well tolerated with mild events, but rarely some children failed or needed a second agent.