(374) Safety and Efficacy of Ketamine-Propofol in Pediatric Magnetic Resonance Imaging

Introduction: Pediatric Magnetic resonance imaging (MRI) can be difficult to obtain in children due to requirement of immobility.
the objective is to evaluate the safety and efficacy of using low-dose ketamine and propofol combination in pediatric patients undergoing MRI in a low middle income country

Methods: A prospective observational study was performed from July 2020 to January 2022. Patients aged six months to 18 years, weighing more than 5 kilograms, and undergoing an MRI with an American Society of Anesthesiology (ASA) classification of ≤2 and a Mallampati score of ≤2 were enrolled through a convenience sampling technique. A p-value of less than 0.05 was considered statistically significant.

Results: A total of 218 patients were included in the final analysis. The mean age was 4.0 ± 3.2 years. MRI was successfully completed in 213 (97.7%) patients. Seizure disorders (n=99, 45.4%) and global developmental delay (GDD) (n=89, 40.8%) were major indications for the MRIs. The mean initial dose of ketamine administered was 0.9 ± 0.2 mg/kg, titrated up to a mean total dose of 1.2 ± 0.5 mg/kg. Similarly, propofol induction was started with a mean dose of 1.1 ± 0.4 mg/kg and titrated to a mean total dose of 2.7 ± 1.4 mg/kg. The mean duration of MRI was 43.8 minutes, and 81.7% of the patients recovered in less than 5 minutes. Most patients had respiratory and hemodynamic stability, and only four required oral/nasal suction.

Conclusions: A combination of low-dose ketamine followed by propofol titration to achieve the desired level of sedation is a feasible technique in children undergoing MRI