(373) Propofol Versus Dexmedetomidine for Shorter Recovery Time After Brain MRI in Pediatric Patients

Introduction: The ideal pediatric sedation agent should provide minimal sedation for patient comfort, a rapid onset, predictable duration, and multiple administration options while ensuring the best therapeutic outcome1. Propofol, a nonopioid agent, has shown promising characteristics with no adverse effects on hepatic or renal functions1-2. However, it has been associated with potential drawbacks such as apnea, hypotension, and lipid emulsion1-2. This study aims to compare the effectiveness of propofol and dexmedetomidine in terms of sedation and recovery time during outpatient brain MRI procedures.

Methods: This retrospective observational analysis was conducted including pediatric patients who underwent moderate sedation for brain MRIs between May 2021-May 2022 at the Imaging Center of a pediatric tertiary teaching hospital in Puerto Rico. The sedative agent used was based on each physician's discretion, and patients undergoing MRI for different anatomical regions or receiving opioids were excluded from the study. Sedation time, recovery time, and total time were compared between patients receiving propofol and dexmedetomidine. Data were presented as median ± SD or percentages. Mann-Whitney test and multivariable regression models were used for statistical analysis.

Results: A total of 721 brain MRIs were conducted, 251 patients met study criteria. 32.3% of patients were 3-5 years old. Most common indications for brain MRIs were: seizures, autism, brain masses, developmental delay, and macrocephaly. Patients in propofol had shorter sedation time, faster discharge, and spent less time in the center as compared to dexmedetomidine. Multivariable regression models showed no relationship between age and propofol use with sedation time, discharge time, and total time. No complications or adverse events were reported.

Conclusions: Patients in propofol had shorter discharge time, consistent with previous studies. However, these findings often excluded younger patients. Based on these results, a sedation protocol is being developed to standardize sedatives use for brain MRIs, aiming to reduce waiting times, and ensure patient safety and comfort.