Abstract

COMPARISON OF SEDATIVE AND HAEMODYNAMIC EFFECTS OF INTRAVENOUS DEXMEDETOMIDINE AND MIDAZOLAM COMBINATION AND INTRAVENOUS DEXMEDETOMIDINE IN CHILDREN UNDERGOING MAGNETIC RESONANCE IMAGING

Author(s): G. K. V. Satyanarayana, Venkata Vommi Ramesh

BACKGROUND Sedation is a necessity for MR procedures conducted in children for adequate alleviation of anxiety, pain relief while securing IV access, and in order to avoid movements during the procedure. Dexmedetomidine, a selective alpha-2 adrenoreceptor agonist is very useful for such procedures. We wanted to analyse and compare the sedative, hemodynamic effect of IV dexmedetomidine with IV dexmedetomidine and midazolam combination in children undergoing magnetic resonance imaging (MRI) examination in terms of, blood pressure before, and half an hour after the administration of sedation, and at the end of the procedure, onset of sedation, recovery from sedation for the initial drug administered, quality of MRI, need for supplementation. METHODS 60 patients studied, were grouped in to two groups- group D and group DM with 30 patients in each group. In group D, inj. Dexmedetomidine at 2 mcg/kg was given IV and in group DM, inj. Dexmedetomidine at a dosage of 2 mcg/kg and inj. Midazolam at a dosage of 0.03 mg/kg were given. Onset of sedation and recovery from sedation were assessed by the Ramsay Sedation Scale and Quality of MRI was assessed using the 3-point scale. Hemodynamic parameters like blood pressure, and need for supplementation of sedation were recorded. RESULTS There was significant difference in onset time of sedation; mean values were 6.3± 2.28 minutes and 3.23 ± 3.02 minutes for D and DM group respectively (p <0.05). There was significant difference in the recovery from Sedation; the mean values were 4.57 ± 0.57 and 5.27 ± 0.52 for D and DM group (p <0.05). There was no significant difference in blood pressure values at various time periods between the two groups (p >0.05). There is a significant difference in the quality of MRI between the two groups (p < 0.05), 4 patients in Group D received supplementation, whereas none in group DM received supplementation. This is statistically significant (p<0.05). CONCLUSIONS Usage of dexmedetomidine for the purpose of sedation is highly advocated and addition of midazolam to dexmedetomidine helped in decreasing the onset time for sedation and also offered a better quality of MRI study without any haemodynamic disturbances.