Initial experience with intravenous pentobarbital sedation for children undergoing MRI at a tertiary care pediatric hospital : the learning curve

• Published in: Pediatric radiology Vol. 30; no. 10; pp. 689 - 691
• Main Authors: GREENBERG, S. Bruce, ADAMS, Ruth C, ASPINALL, Carol L
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01-10-2000; Springer Nature B.V
• Subjects: Adolescent; Age Factors; Biological and medical sciences; Body Weight; Child; Child, Preschool; Endocrine glands; Humans; Hypnotics and Sedatives - administration & dosage; Hypnotics and Sedatives - adverse effects; Injections, Intravenous; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Medical sciences; Pentobarbital - administration & dosage; Pentobarbital - adverse effects; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Human; Intravenous administration; Indication; Pentobarbital; Anesthesia; Medical imagery; Sedation; Barbiturates; Child; Nuclear magnetic resonance imaging; Premedication
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s002470000304

Our purpose is to describe the initial experience with intravenous pentobarbital sedation in children undergoing MRI at a tertiary pediatric hospital to identify errors associated with inexperience.
The study included the first 100 children sedated with intravenous pentobarbital prior to magnetic resonance examination at a tertiary pediatric hospital. The protocol included a maximum dose of 6 mg/kg administered in three divided doses with the total dose not to exceed 200 mg. Flow sheets documenting vital signs, administered drug doses, and adverse reactions were maintained contemporaneous to sedation.
Sedation was successful in 92 children. Of the eight children who failed sedation, three were at least 12 years old and three weighed more than 50 kg. chi2 tests identified significantly greater failure rates in children older than 11 years or weight greater than 50 kg. Two children had prolonged sedation after the maximum suggested dose was exceeded.
The success rate was good, but could have been improved by restricting the use of pentobarbital to children less than 12 years of age and weighing less than 50 kg. Radiologists inexperienced with intravenous sedation should strictly observe the maximum suggested dose of pentobarbital to prevent prolonged sedation.