Table 3. Sedation and Recovery Profiles and Adverse Events.
| Variable | Propofol group | Propofol-ketamine group | Relative risk (95% CI) or median difference (95% CI) | P value |
|---|---|---|---|---|
| During MRI | ||||
| No. of patients | 54 | 53 | NA | NA |
| Sedation duration, median (IQR), min | 37 (30 to 43) | 36 (29 to 41) | 1.0 (−3.0 to 4.0) | .66 |
| Anesthetic administration | ||||
| Induction dose of propofol, median (IQR), mg/kg | 2.7 (2.0 to 3.6) | 1.0 (1.0 to 1.0) | 1.1 (1.0 to 1.8) | <.001 |
| Additional boluses to sedate, No. | ||||
| 0 | 22 | 48 | NA | <.001 |
| 1 | 18 | 5 | ||
| 2 | 9 | 0 | ||
| 3 | 4 | 0 | ||
| 4 | 1 | 0 | ||
| Propofol, median (IQR), mg/kg/min | 0.31 (0.27 to 0.35) | 0.17 (0.14 to 0.22) | 0.1 (0.1 to 0.2) | <.001 |
| Ketamine, mean (SD), mg/kg/min | NA | 0.05 (0.02) | NA | NA |
| Adverse events, No. (%) | ||||
| Tachycardia | 4 (7.4) | 6 (11.3) | 1.5 (0.5 to 5.1) | .53 |
| Bradycardia | 4 (7.4) | 3 (5.7) | 0.8 (0.2 to 3.3) | >.99 |
| Hypertension | 5 (9.3) | 18 (34.0) | 3.7 (1.5 to 9.2) | .002 |
| Hypotension | 38 (70.4) | 24 (45.3) | 0.6 (0.5 to 0.9) | .009 |
| Desaturation | 2 (3.7) | 2 (3.8) | 1.0 (0.1 to 7.0) | >.99 |
| Airway intervention | 4 (7.4) | 1 (1.9) | 0.3 (0.0 to 2.2) | .18 |
| Movement event | 4 (7.4) | 10 (18.9) | 2.5 (0.9 to 7.6) | .08 |
| Interruption of MRI | 7 (13.0) | 8 (15.1) | 1.2 (0.5 to 3.0) | .75 |
| Miscellaneous | 1 (1.9) | 0 | 0.3 (0.0 to 8.2) | >.99 |
| Quality of MRI, median (IQR) (score, 1-5)a | 5 (4 to 5) | 5 (5 to 5) | 0.0 (0.0 to 0.0) | .26 |
| During PACU stay | ||||
| No. of patients | 54 | 53 | NA | NA |
| PACU stay, median (IQR), min | 30 (30 to 32) | 30 (30 to 30) | 0.0 (0.0 to 0.0) | .02 |
| Time to emergence, median (IQR), min | 25 (22 to 27) | 15 (9 to 23) | 9.0 (6.0 to 12.0) | <.001 |
| Emergence delirium, No. (%) | 10 (18.5) | 6 (11.3) | 0.6 (0.2 to 1.6) | .32 |
| Nurse satisfaction score, median (IQR) (range, 0-10)b | 9 (8 to 9) | 10 (9 to 10) | −1.0 (−1.0 to 0.0) | .006 |
| Adverse events, No. (%) | 7 (13.0) | 10 (18.9) | 1.5 (0.6 to 3.5) | .40 |
| Dizziness | 5 (9.3) | 6 (11.3) | 1.2 (0.4 to 3.8) | .70 |
| Nausea | 1 (1.9) | 3 (5.7) | 3.1 (0.3 to 28.5) | .35 |
| Vomiting | 0 | 0 | NA | NA |
| Others | 1 (1.9) | 1 (1.9) | 1.0 (0.1 to 16.2) | >.99 |
| Within 24 h after sedationc | ||||
| Patients who did not respond to telephone calls, No. | 52 | 50 | NA | NA |
| Parent satisfaction scored | ||||
| 1 | 0 | 0 | NA | .01 |
| 2 | 0 | 0 | ||
| 3 | 7 | 0 | ||
| 4 | 5 | 10 | ||
| 5 | 40 | 50 | ||
| Adverse events, No. (%) | 26 (50.0) | 15 (30.0) | 0.6 (0.4 to 1.0) | .04 |
| Dizziness | 10 (19.2) | 10 (20.0) | 1.0 (0.5 to 2.3) | .92 |
| Drowsiness | 11 (21.2) | 6 (12.0) | 0.6 (0.2 to 1.4) | .22 |
| Respiratory complications | 13 (25.0) | 1 (2.0) | 0.1 (0.0 to 0.6) | .001 |
| Fever | 10 | 0 | 0.0 (0.0 to 0.8) | .04 |
| Cough | 7 | 1 | 0.1 (0.0 to 1.2) | .07 |
| Sputum | 1 | 0 | 0.1 (0.0 to 2.2) | .15 |
| Other | 0 (0.0) | 1 (2.0) | 3.1 (0.1 to 73.4) | .49 |
Abbreviations: MRI, magnetic resonance imaging; NA, not applicable; PACU, postanesthesia care unit.
a
The MRI quality was evaluated using a 5-point Likert scale (1, not acceptable at all; 2, diagnosis impossible; 3, single protocol not acceptable; 4, acceptable; and 5, very good).
b
Nurse satisfaction was evaluated using an 11- point numeric rating scale (with 0 indicating extremely difficult to manage to 10 indicating extremely easy to manage).
c
Denominators that do not equal the sample sizes are due to missing data.
d
Parent satisfaction was evaluated using a 5-point Likert scale (1, very dissatisfied; 2, somewhat dissatisfied; 3, neutral; 4, somewhat satisfied; and 5, very satisfied).