Dexmedetomidine Sedation in a Pediatric Cardiac Patient Scheduled for MRI

Purpose: To describe the use of dexmedetomidine for sedation in a critically ill infant undergoing magnetic resonance imaging (MRI).

Clinical Features: A nine-month-old 5.1 kg infant was to have an MRI study of the thorax. The infant had multiple congenital cardiac anomalies which had been partially corrected surgically. After administration of atropine, 0.1 mg iv, a loading dose of dexmedetomidine (1 microg.kg(-1) iv) was administered over ten minutes followed by a continuous infusion of 0.5 microg.kg(-1).hr(-1) for maintenance. Propofol 5 mg iv were administered after the loading dose of dexemedetomidine to produce somnolence. Anesthetic conditions for performing the MRI were excellent. The infant remained motionless, breathing spontaneously. Hemodynamics remained stable throughout the procedure. Recovery was rapid and uneventful.

Conclusion: Dexmedetomidine and a small dose of propofol were used successfully to sedate a critically ill infant for MRI. More studies are required to determine the role of this unique drug in the pediatric population.