Safety and Efficacy of Ketamine-Propofol in Pediatric Magnetic Resonance Imaging: A Prospective Study

The present study aimed to evaluate the safety and efficacy of using low-dose ketamine and propofol combination in pediatric patients undergoing MRI.A prospective observational study was performed from July 2020 to January 2022. Patients aged six months to 18 years, weighing more than 5 kilograms, and undergoing an MRI with an American Society of Anesthesiology (ASA) classification of ≤2 and a Mallampati score of ≤2 were enrolled through a convenience sampling technique. A p-value of less than 0.05 was considered statistically significant. A total of 218 patients were included in the final analysis. The mean age was 4.0 ± 3.2 years. MRI was successfully completed in 213 (97.7%) patients. Seizure disorders (n=99, 45.4%) and global developmental delay (GDD) (n=89, 40.8%) were major indications for the MRIs. The mean initial dose of ketamine administered was 0.9 ± 0.2 mg/kg, titrated up to a mean total dose of 1.2 ± 0.5 mg/kg. Similarly, propofol induction was started with a mean dose of 1.1 ± 0.4 mg/kg and titrated to a mean total dose of 2.7 ± 1.4 mg/kg. The mean duration of MRI was 43.8 min, and 81.7% of the patients recovered in less than 5 min. Most patients had respiratory and hemodynamic stability, and only four required oral/nasal suction. A combination of low-dose ketamine followed by propofol titration to achieve the desired level of sedation is a feasible technique in children undergoing MRI.