Propofol total intravenous anesthesia for MRI in children

Background: The aim of this study was to assess clinical signs of airway patency, airway intervention requirements and adverse events in 100 children receiving propofol total intravenous anesthesia for magnetic resonance imaging, with spontaneous ventilation and oxygenation via nasal prongs. Methods: Airway patency was clinically assessed and stepwise interventions were performed until a satisfactory airway was achieved. Propofol requirements, vital signs, procedure times and adverse events were also recorded. Results: Ninety-three per cent of children had no signs of airway obstruction when positioned with a shoulder roll only, two required a chin lift, four required an oral airway and one required lateral positioning. The mean propofol induction dose was 3.9 mg.kg(-1) (range 1.8-6.4 mg.kg(-1)). The mean propofol infusion rate was 193 mug.kg(-1).min(-1) (range 150-250 mug.kg(-1).min(-1)). The initial and final mean respiratory rates were 26 and 23 b.min(-1) (P < 0.05). Movement was more likely at lower infusion rates (mean 175 mug.kg(-1).min(-1)). There were no respiratory or cardiovascular complications (calculated risk: 95% CI = 0-3%). The mean time from end of scan to discharge home was 44 min. Conclusions: This study demonstrates good preservation of upper airway patency and rapid recovery using general anesthetic doses of propofol in children.