Sedation in children undergoing magnetic resonance imaging comparative study between dexmedetomidine and ketamine

Peer review under responsibility of Egyptian Society of Anesthesiologists.

Figures & data

able 1 Ramsay sedation assessment scale.

Awake levels	Patient anxious or agitated or both	1
	Patient cooperative, oriented and tranquil	2
	Patient responds to commands only	3
Asleep levels	A brisk response to a light glabellar tap	4
	A sluggish response to a light glabellar tap	5
	No response	6

able 2 Patient characteristics, duration, and type of magnetic resonance imaging procedures.

Patient characteristic, procedure	Group D (n = 55)	Group K (n = 55)	Significant
Age (yr)	5 ± 1.67	5 ± 1.53	NS
Weight (kg)	14 ± 4.03	14 ± 4.73	NS
Sex (male/female)	33/22	26/29	NS
Presedation behavior score
#x2013; Undistressed (scores 1 & 2)	29	28
#x2013; Distressed (scores 3 & 4)	26	27
Duration of MRI (min)	35 ± 32	38 ± 37.12	NS
Cranial MRI	32	30	NS
Extremity MRI	6	7	NS
Spine	7	9	NS
Thorax and abdomen	10	9	NS

Data are expressed as mean ± SD, numbers (n).

Group D (=dexmedetomidine); group K (=ketamine).

P > 0.05 = non-significant and N/S = non significant.

able 3 Results of sedation, duration of study drug infusion and adverse effects.

Inadequate sedation	Group D (n = 55)	Group K (n = 55)	P value
Sedation failure	6	4
Onset of sedation time (min)	15 ± 3.0	5 ± 1.54	0.010
Duration of study drug infusion (min)	49 ± 14.81	52 ± 15.76	0.030
Adverse effects
#x2013; Emesis	0	1	NS
#x2013; Agitation and dysphoric reaction	0	2	NS
#x2013; Apnea	0	0
#x2013; Desaturation	6	5	NS
#x2013; Recovery time (min)	20 ± 4.65	21 ± 05.22	0.020
#x2013; Discharge time (min)	30 ± 18.35	50 ± 14.35	0.030

Data are expressed as mean ± SD, numbers (n).

P > 0.05 = non-significant while P < 0.05 is significant.

N/S = non-significant.

able 4 Hemodynamic and respiratory changes during study drug infusion.

Time (min)	Baseline	5	15	30	45	P Value
MAP
Group K	90 ± 5.88	75 ± 7.53	74 ± 9.7	73 ± 8.35	76 ± 6.72^§	0.026
	84 ± 10.6	92 ± 9.34	88 ± 8.42	95 ± 7.54	91 ± 0.53	0.029
^⁎P value	NS	0.024	0.014	0.026	0.021
HR
Group D	115 ± 11.69	92 ± 0.75	90 ± 0.86	94 ± 4.61	96 ± 4.3	0.038
Group K	109 ± 9.73	120 ± 8.59	119 ± 0.89	123 ± 5.57	119 ± 5.4	0.036
^⁎P value	NS	0.029	0.033	0.034	0.027
RR (respiratory rate)
Group D	26 ± 2.68	24 ± 3.72	24 ± 3.64	24 ± 3.83	24 ± 3.32	N/S
Group K	25 ± 0.59	22 ± 4.35	19 ± 4.86	17 ± 0.5	18 ± 1.7	0.022
^⁎P value	NS	NS	0.018	0.022	0.021
SpO2
Group D	96 ± 3.76	98 ± 2.06	94 ± 5.47	96 ± 3.25	95 ± 2.79	N/S
Group K	95 ± 84.24	97 ± 3.43	95 ± 4.62	97 ± 2.93	96 ± 1.9	N/S
^⁎P value	NS	NS	NS	NS	NS

Data are expressed as mean ± SD, P > 0.05 = non-significant (NS) comparing with baseline.

#x204E; P < 0.05 is significant, comparing D group with K group.