AI Article Synopsis
- The study evaluates the effectiveness of dexmedetomidine alone versus its combination with other sedatives (ketamine, propofol, midazolam) in pediatric patients undergoing MRI based on hemodynamic stability, recovery time, and respiratory function.
- Of the 106 studies reviewed, 17 were selected, encompassing 3,430 pediatric patients, indicating that dexmedetomidine provides better hemodynamic stability but results in a longer recovery time compared to other sedatives.
- The findings suggest that combining dexmedetomidine with other sedatives leads to more stable hemodynamics and shorter recovery times, making such combinations preferable for sedation during MRI.
Article Abstract
Aim To compare the outcome of sole dexmedetomidine or with other sedative drugs in paediatric patients during magnetic resonance imaging (MRI). Methods Literature was obtained from PubMed and ScienceDirect from 2010-2020 using key words: sedation, paediatric, dexmedetomidine, ambulatory, MRI, ketamine, propofol, midazolam. The literature selection was based on Participant, Intervention, Comparators, Outcomes (PICO) analysis. All English full-text and peer-reviewed articles were included. The primary outcome was hemodynamic stability, respiratory compromise, and recovery time. The risk of bias analysis was assessed using Cochrane collaboration Risk of Bias (RoB 2.0). Result Of 106 studies, 17 studies were included with a total 3.430 paediatric patients undergoing MRI. Dexmedetomidine alone provides a more stable hemodynamic but longer recovery time than ketamine, propofol or midazolam. The combination of dexmedetomidine and ketamine provides more stable hemodynamics, especially in the incidence of hypotension and bradycardia, and does not significantly reduce airway configuration more than sole dexmedetomidine or ketamine. Intranasal dexmedetomidine is more recommended than its combination with midazolam. Combining dexmedetomidine with ketamine, propofol or midazolam provides a shorter recovery time. Conclusion A combination of dexmedetomidine with other sedatives such as ketamine, propofol and midazolam is better than sole dexmedetomidine for paediatric sedation during magnetic resonance imaging.
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