Abstract
Purpose
To describe the use of dexmedetomidine for sedation in a critically ill infant undergoing magnetic resonance imaging (MRI). Clinical features: A nine-month-old 5.1 kg infant was to have an MRI study of the thorax. The infant had multiple congenital cardiac anomalies which had been partially corrected surgically. After administration of atropine, 0.1 mg iv, a loading dose of dexmedetomidine (1 μg·kg-1 iv) was administered over ten minutes followed by a continuous infusion of 0.5 μg·kg-1·hr-1 for maintenance. Propofol 5 mg iv were administered after the loading dose of dexemedetomidine to produce somnolence. Anesthetic conditions for performing the MRI were excellent. The infant remained motionless breathing spontaneously. Hemodynamics remained stable throughout the procedure. Recovery was rapid and uneventful.
Conclusion
Dexmedetomidine and a small dose of propofol were used successfully to sedate a critically ill infant for MRI. More studies are required to determine the role of this unique drug in the pediatric population.
Résumé
Objectif
Décrire ľusage de dexmédétomidine pour la sédation ďune enfant gravement malade devant subir un examen ďimagerie par résonance magnétique (IRM).
Éléments cliniques
Une enfant de 9 mois, pesant 5,1 kg, devait subir un examen du thorax par IRM. Elle avait de multiples anomalies cardiaques congénitales, partiellement corrigées chirurgicalement. Après ľadministration iv de 0,1 mg ďatropine, une dose de charge de dexméédétomidine (1 μg·kg-1iv) a été administrée pendant 10 minutes, suivie ďune perfusion continue de maintien de 0,5 μg·kg-1·h-1. Après la dose de charge de dexmédétomidine, 5 mg de propofol iv ont été administrés pour produire la somnolence. Les conditions anesthésiques étaient excellentes pour réaliser ľIRM. Ľenfant est demeurée immobile et respirait spontanément. Ľhémodynamique a été stable tout au long de ľexamen. La récupération a été simple et rapide.
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Young, E.T. Dexmedetomidine sedation in a pediatric cardiac patient scheduled for mri. Can J Anesth 52, 730–732 (2005). https://doi.org/10.1007/BF03016562
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DOI: https://doi.org/10.1007/BF03016562