Abstract
Magnetic resonance imaging (MRI) is a widely applied diagnostic approach for detection of pediatric diseases. Sedatives are commonly used to acquire the accurate MRI images. Dexmedetomidine and propofol serve as sole or combined sedatives in pediatric MRI scanning. This meta-analysis aimed to compare the efficacy of dexmedetomidine and propofol in children ubdergoing MRI. Pubmed, Cochrane Library and Web of Science were searched up to June, 2017. Onset of sedation time, recovery time, sedation time, MRI time, MRI quality and emergence delirium were analyzed. 6 studies with 368 subjects were enrolled in this meta-analysis. The pooling data showed that propofol had a shorter onset of sedation time (WMD: 6.05, 95% CI: 3.12 – 8.98, P < 0.0001) and recovery time (WMD: 1.01, 95% CI: 0.36–1.67, P < 0.001) than dexmedetomidine. But for sedation time and MRI scanning time, there were no differences between the two groups (sedation time: P = 0.29; MRI scanning time: P = 0.50). There were no significance between dexmedetomidine and propofol on MRI quality (MRI quality 1: P = 1.00; MRI quality 2: P = 0.68; MRI quality 3: P = 0.45). Two studies using Pediatric Anesthesia Emergence Delirium (PAED) to assess emergence delirium 10 minutes after awakening showed that propofol had a lower PAED than dexmedetomidine (WMD: 2.57, 95% CI: 0.15–5.00, P = 0.04). Thus, propofol should be encouraged in pediatric patients undergoing MRI for its better sedative effects and a low incidence of emergence delirium.
Highlights
Magnetic resonance imaging (MRI) has become a widely applied diagnostic tool for a series of pediatric diseases [1,2,3]
The pooling data showed that propofol had a shorter onset of sedation time (WMD: 6.05, 95% confidence intervals (CIs): 3.12 – 8.98, P < 0.0001) and recovery time (WMD: 1.01, 95% CI: 0.36–1.67, P < 0.001) than dexmedetomidine
Two studies using Pediatric Anesthesia Emergence Delirium (PAED) to assess emergence delirium 10 minutes after awakening showed that propofol had a lower PAED than dexmedetomidine (WMD: 2.57, 95% CI: 0.15–5.00, P = 0.04)
Summary
Magnetic resonance imaging (MRI) has become a widely applied diagnostic tool for a series of pediatric diseases [1,2,3]. This non-invasive, accurate but timeconsuming diagnostic approach requires the pediatric examinees to fully cooperate without motion during the operation [4]. Dexmedetomidine and propofol are commonly used in clinical practice for their specific efficacy and safety characteristics [5, 6]. Both of them have a short sedation and recovery time. A meta-analysis was needed to evaluate the effects of dexmedetomidine and propofol in pediatric MRI imaging
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