Success Rate Compared between Sevoflurane Insufflation via Simple Oxygen Mask and Propofol Intravenous Infusion in Small Children Undergoing MRI: A Randomized Controlled Trial
Suppachai Poolsuppasit MD1, Bencharatana Yok-ubol MD1, Phuriphong Songarj MD1, Choopong Luansritisakul MD1, Sirirat Rattanaarpa MD1, Garnphipak Heerungeeragon MD1, Apapit Laoporn MD1, Kanitha Kraiprasit RN1, Krongthip Sripunjan RN1
Affiliation : 1 Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To compare the success rate between sevoflurane insufflation via simple oxygen mask and propofol intravenous
infusion in children aged 1 to 6 years undergoing magnetic resonance imaging [MRI].
Materials and Methods : This randomized controlled trial was conducted in pediatric patients aged 1 to 6 years who were
scheduled to undergo MRI scan at the Faculty of Medicine Siriraj Hospital during the October 1, 2015 to October 31, 2016
study period. Patients were randomized into the sevoflurane insufflation (2% sevoflurane) via simple oxygen mask group or
the propofol intravenous infusion (propofol 100 mcg/kg/min) group. The primary outcome was success rate of MRI scan,
defined as scan completed without any pause. Causes of interruption during MRI, including hypotension, bradycardia,
hypoventilation, desaturation, and movement, were recorded and analyzed. Secondary outcomes were Pediatric Anesthesia
Emergence Delirium [PAED] scale, postoperative nausea and vomiting [PONV], and MRI quality.
Results : One hundred and forty-four pediatric patients were included. Sevoflurane insufflation yielded a significantly higher
MRI success rate than propofol infusion (69.4% vs. 48.6% respectively; p = 0.011). No significant differences were
observed between groups for hypotension, movement, or hypertension. Bradycardia occurred significantly more often in the
propofol group than in the sevoflurane group (p = 0.043). Emergence time was significantly shorter in the sevoflurane group
than in the propofol group (26.1+16.7 vs. 32.2+17.4 minutes, respectively; p = 0.040). There was no significant difference
between groups for PAED scale, PONV, or MRI quality.
Conclusion : The present study found a significantly higher MRI success rate in the sevoflurane insufflation group than in
the propofol infusion group. Sevoflurane insufflation technique should be considered a safe and effective method of anesthe-
sia for small children undergoing painless imaging procedures.
Keywords : Insufflation, MRI, Children, Sevoflurane, Propofol
