Brain Diseases Clinical Trial
Official title:
Comparative Study of Dexmedetomidine-midazolam Combination and Propofol-midazolam Combination for MRI Brain in Paediatric Patient
MRI though not painful requires deep sedation for children due to the loud noise created.
With deep sedation comes respiratory depression so the interest in Dexmedetomidine. For
standardization MRI brain was chosen and also for the fact that patients usually have
history of convulsions where drugs like ketamine may not be a good option. Patients were
recruited after ethics committee approval. After pre-medication with intranasal midazolam
0.2 mg/kg body weight, Intravenous access was established and then patients were divided in
two groups. One group received intravenous propofol 2mg/Kg and infusion of 100mcg/per kg
body weight per minute. The other group received intravenous bolus of Dexmedetomidine
1mcg/kg over 10 minutes and then a infusion of Dexmedetomidine 1mcg/kg/hour.
Primary out come was to study the recovery time of patients sedated with Dexmedetomidine
compared to patients sedated with propofol for paediatric MRI brain. Secondary outcome were
analysed in terms of time for induction,procedural disruptions due to awakening and
haemodynamic stability . Follow up was done on phone for any adverse events.
Patients were evaluated on out patient department basis. On the day of MRI nil per oral
status of 6 hours was confirmed and consent taken from the parent. In recovery room after
recording of vitals, children were given intranasal midazolam 0.2mg/kg body weight. The
intravenous line was secured after the child was sedated. Patients were then divided in two
groups. In the MRI console, the dexmedetomidine group received intravenous dexmedetomidine
1mcg/kg body weight over 10 minutes. An intravenous infusion of dexmedetomidine was then
started at 1mcg/kg/hour.
The propofol group received 2mg /kg of intravenous propofol and an infusion of
100mcg/kg/minute.
MRI monitoring included pulseoximetry, cardioscope, respiratory pattern and rate. Oxygen was
delivered by nasal prongs. Primary outcome measured was the time for recovery.
Secondary outcomes were number of awakening during procedure, haemodynamic stability,
induction time and any adverse events.
After MRI the children were observed in the recovery room and discharged after achieving
'modified aldred score' of 10. Vitals and any adverse events were recorded during this
phase.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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