Choice of anesthetic support components for children during MRI procedures

Introduction. An MRI-scan in early childhood requires anesthesia to create complete immobility of the patient due to the high incidence of artifacts with an MRI duration of 40 to 60 minutes. The purpose of the work is to select the components of anesthetic support in children from one month to three years old with MRI.

Materials and methods. The object of the study was 33 patients aged one month to three years with congenital and acquired brain pathology. Anesthetic management — intravenous general anesthesia without mechanical ventilation. Anesthesia in 11 (33.3%) patients of group 1 — midazolam 0.5% 0.3 mg/kg, in 12 (36.4%) patients of group 2 — midazolam 0.5% at a dose of 0.3 mg/kg + ketamine 5% 1.5 mg/kg, and in 10 (30.3%) patients of group 3 — midazolam 0.5% at a dose of 0.3 mg/kg + propofol 2 mg/kg.

Results. Group 1 patients achieved a sedation level on the RASS scale of –2.2 ± 0.1 points with preservation of sound and tactile sensitivity, spontaneous involuntary movements limbs in 72.7% of cases. Group 2 patients had a lack of motor activity, consciousness - an assessment on the RASS scale — –4.6 ± 0.4 points, BIS — 59.4 ± 1%, increased in blood pressure by 7.3%, and normal without depression of respiratory function. Group 3 patients required careful titration of each subsequent dose, constant monitoring of breathing and hemodynamics, and, if necessary, maintaining adequate ventilation during the induction stage.

Conclusion. The most rational components for anesthesia support in young children during MRI scanning are midazolam solutions at a dose of 0.3 mg/kg and ketamine at 1.5/kg.