Airway Dimensions in Children with Neurological Disabilities During Dexmedetomidine and Propofol Sedation for Magnetic Resonance Imaging Study

Özet

Objective: Children with neurological disabilities are at an increased risk of airway complications during anaesthesia for magneticresonance imaging (MRI) with spontaneous respiration. The primary objective of this study was to evaluate airway dimensions duringpropofol and dexmedetomidine sedation for MRI in children with neurological disabilities. The secondary objective was to examine theadverse respiratory and sedation-related events.Methods: Seventy-two children aged 1–6 years undergoing MRI were randomly selected to receive sedation with either 2 mg kg−1 h−1 ofpropofol or 2 µg kg−1 h−1 of dexmedetomidine. The airway dimensions were measured at soft palate, the base of tongue and mid-epiglottis.Adverse airway events were noted, and the quality of sedation was determined based on the need for dose modification, patient movementand repeat imaging requirements.Results: There was no significant difference in airway dimensions observed between the dexmedetomidine and propofol groups, except for maximumand minimum transverse diameter (15.4±3.4 vs. 13.4±4.7, p=0.04 and 14.6±3.3 vs. 12.4±4.7, p=0.02 respectively) at soft palate and forcross sectional area difference at the base of tongue (14.5±13.9 vs. 20.1±19.3, p=0.03). Airway obstruction (2/36 vs. 3/36), apnoea (0/36 vs. 3/36)and desaturation (0/36 vs 2/36) occurred less frequently with dexmedetomidine. Additional requirement of sedation (6 vs. 3 patients; p=0.48),movement during imaging (9 vs. 5 patients; p=0.37) and poor image quality necessitating re-acquisition (4 vs. 0 patients; p=0.08) were morefrequent with propofol.Conclusion: Airway dimensions were similar during dexmedetomidine and propofol sedation, except for the transverse diameters atsoft palate, and for cross-sectional area difference at the base of tongue in spontaneously breathing children with neurological disabilities.Airway complications were less frequent and the quality of sedation was better with dexmedetomidine.