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This is a pilot study to determine if a standard bolus dose and infusion of dexmedetomidine can significantly decrease the dose of propofol (infusion) required for accomplishing an MRI. The investigators studied three arms to examine the effectiveness of dexmedetomidine. Arm 1 was a single bolus of 1.0 mcg/kg with 1.0 mcg/kg/hr infusion followed by propofol infusion. Arm 2 was a bolus of 1.0 mcg/kg with 0.5 mcg/kg/hr infusion followed by propofol infusion. Arm 3 was only a single bolus of 1.0 mcg/kg with no infusion followed by propofol infusion.
A recent publication in the New England Journal of Medicine highlighted the accumulating evidence for neurotoxic effects of anesthetics in animal models and a collection of epidemiologic studies in humans. Recent studies of anesthesia in fetal and neonatal primates are yielding more evidence of neurotoxicity associated with many common anesthesia and sedation techniques (e.g. propofol, etomidate, sevoflurane, desflurane and isoflurane). On the other hand, the data suggests that some alternative sedative agents, such as Dexmedetomidine, may not have the same neurotoxic effect.
Children routinely undergo sedation for MRI scanning with large doses of propofol and other sedatives. Many of these scans occur at young ages when these children may be at risk of neurological injury from sedative exposure. In addition, these scans do not involve any stimulation - which could be protective against neurodegeneration.
The investigators propose a pilot study to determine if a standard bolus dose and infusion of dexmedetomidine can significantly decrease the dose of propofol (infusion) required for accomplishing an MRI. Based on previous work with the combination of propofol with dexmedetomidine for other procedures, the investigators propose a standard dose of dexmedetomidine (1 mcg/kg bolus followed by an infusion at 1.0 mcg/kg/hour, 0.5 mcg/kg/hour, or no infusion). The investigators will augment this sedation with propofol 2-3 mg/kg titrated bolus followed by 100 mcg/kg/min infusion which can also be titrated up or down to a maximum of 300 mcg/kg/min to keep the blood pressure and heart rate within 30% of baseline levels).
The investigators hypothesize that the use of low dose propofol with dexmedetomidine will be effective undergoing MRI while sparing exposure to the high dose of the sedative.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dexmedetomidine (bolus and high infusion)-Propofol arm | Other | Patients in this cohort will receive a combination of Dexmedetomidine 1mcg/kg bolus, Dexmedetomidine 1 mcg/kg/hour infusion, and Propofol 100mcg/kg/minute to accomplish an MRI examination. |
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| Dexmedetomidine (bolus and low infusion)-Propofol arm | Other | Patients in this cohort will receive a combination of Dexmedetomidine 1mcg/kg bolus, Dexmedetomidine 0.5 mcg/kg/hour infusion, and Propofol 100mcg/kg/minute to accomplish an MRI examination. |
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| Dexmedetomidine (bolus only)-Propofol arm | Other | Patients in this cohort will receive dexmedetomidine 1mcg/kg over 5 minutes and then propofol 2-3mg/kg titrated bolus followed by 100mcg/kg/min infusion to accomplish MRI |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dexmedetomidine bolus and high infusion-Propofol | Drug | First, the investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. Next, the investigators will begin an infusion at 1mcg/kg/hour. At the 5 minute point, propofol will be given (2-3mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose of Dexmedetomidine will not be changed. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure and sedation will continue at the discretion of the anesthesiologist. |
| Measure | Description | Time Frame |
|---|---|---|
| Dosage/Consumption | Dosage and consumption of dexmedetomidine infusion | Prior to beginning the MRI and throughout the MRI scan - approximately one hour. |
| Incidence of Patient Movement and MRI Interruption | If patient moved during their MRI and caused an interruption of the scan. | During the MRI scan, until completion, approximately one hour. |
| Incidence of Adverse Events | arterial desaturation, airway obstruction, hypotension and bradycardia | From the time the medication is initiated just (5 minutes) prior to the MRI scan and during the MRI scan and immediately during recovery - approximately one hour and twenty minutes in total. |
| Case Times | Number of minutes from the start of sedation medication administration to the time the patient is adequately sedated for the MRI scan, | Timeframe immediately before the MRI scan while sedation medication is administered - approximately 10 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Technique Failure | lack of adequate sedation for MRI scan in spite of the sedation as described above | During the MRI scan until completion - approximately one hour |
| Sedation Infusion Time |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Joseph Cravero, MD | Boston Children's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Boston Children's Hospital | Boston | Massachusetts | 02115 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25714157 | Background | Rappaport BA, Suresh S, Hertz S, Evers AS, Orser BA. Anesthetic neurotoxicity--clinical implications of animal models. N Engl J Med. 2015 Feb 26;372(9):796-7. doi: 10.1056/NEJMp1414786. | |
| 24814202 | Background | Wu J, Mahmoud M, Schmitt M, Hossain M, Kurth D. Comparison of propofol and dexmedetomedine techniques in children undergoing magnetic resonance imaging. Paediatr Anaesth. 2014 Aug;24(8):813-8. doi: 10.1111/pan.12408. Epub 2014 May 12. |
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Patients were recruited from 3.2.2017 and the final patient was enrolled 9.6.2022. Recruitment occurred after mail and phone contact approximately 2 weeks before the study and consent was obtained on the day of the study.
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| ID | Title | Description |
|---|---|---|
| FG000 | Dexmedetomidine (High)-Propofol Arm | The investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. Next, the investigators will begin an infusion at 1mcg/kg/hour. At the 5 minute point, propofol will be given (2mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose of Dexmedetomidine will not be changed. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jul 14, 2021 |
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| Dexmedetomidine bolus and low infusion-Propofol | Drug | First, the investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. Next, the investigators will begin an infusion at 0.5mcg/kg/hour. At the 5 minute point, propofol will be given (2-3mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose of Dexmedetomidine will not be changed. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure and sedation will continue at the discretion of the anesthesiologist. |
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| Dexmedetomidine bolus only - Propofol | Drug | First, the investigators will begin by administering dexmedetomidine 1mcg/kg over 5 minutes. When this is completed, they will administer propofol 2-3mg/kg titrated bolus followed by 100mcg/kg/min infusion which can also be titrated up or down to a maximum of 300mcg/kg/min to keep the blood pressure and heart rate within 30% of baseline levels. |
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The number of minutes that the patient was receiving dexmedetomidine infusion
| For the duration of the MRI scan - approximately one hour |
| Case Duration | total number of minutes in the MRI scanner, | Duration of the MRI scan - approximately one hour |
| Recovery Time | number of minutes in the recovery area until the patient appeared awake (eye opening), | from completion of the MRI scan until prepared for discharge - approximately 90 minutes |
| 17683409 | Background | Heard CM, Joshi P, Johnson K. Dexmedetomidine for pediatric MRI sedation: a review of a series of cases. Paediatr Anaesth. 2007 Sep;17(9):888-92. doi: 10.1111/j.1460-9592.2007.02272.x. |
| 12006795 | Background | Triltsch AE, Welte M, von Homeyer P, Grosse J, Genahr A, Moshirzadeh M, Sidiropoulos A, Konertz W, Kox WJ, Spies CD. Bispectral index-guided sedation with dexmedetomidine in intensive care: a prospective, randomized, double blind, placebo-controlled phase II study. Crit Care Med. 2002 May;30(5):1007-14. doi: 10.1097/00003246-200205000-00009. |
| FG001 | Dexmedetomidine (Low)-Propofol Arm | The investigators will administer dexmedetomidine 1 mcg/kg over 5 minutes. Next, the investigators will begin an infusion at 0.5 mcg/kg/hour. At the 5 minute point, propofol will be given (2mg/kg bolus followed by 100 mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2 mg/kg will be administered. The dose of Dexmedetomidine will not be changed. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure and sedation will continue at the discretion of the anesthesiologist. |
| FG002 | Dexmedetomidine (Bolus Only)-Propofol Arm | The investigators will administer dexmedetomidine 1 mcg/kg over 5 minutes. At the 5 minute point, propofol will be given (2 mg/kg bolus followed by 100 mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2 mg/kg will be administered. The dose of Dexmedetomidine will not be changed. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure and sedation will continue at the discretion of the anesthesiologist. |
| COMPLETED |
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| NOT COMPLETED |
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The 1st, 2nd, and 3rd arms of this study have been completed and are shown here.
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| ID | Title | Description |
|---|---|---|
| BG000 | Dexmedetomidine (High)-Propofol Arm | The investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. Next, the investigators will begin an infusion at 1mcg/kg/hour. At the 5 minute point, propofol will be given (2mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose of Dexmedetomidine will not be changed. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure and sedation will continue at the discretion of the anesthesiologist. |
| BG001 | Dexmedetomidine (Low)-Propofol Arm | The investigators will administer dexmedetomidine 1 mcg/kg over 5 minutes. Next, the investigators will begin an infusion at 0.5 mcg/kg/hour. At the 5 minute point, propofol will be given (2mg/kg bolus followed by 100 mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2 mg/kg will be administered. The dose of Dexmedetomidine will not be changed. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure and sedation will continue at the discretion of the anesthesiologist. |
| BG002 | Dexmedetomidine (Bolus Only)-Propofol Arm | The investigators will administer dexmedetomidine 1 mcg/kg over 5 minutes. At the 5 minute point, propofol will be given (2 mg/kg bolus followed by 100 mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2 mg/kg will be administered. The dose of Dexmedetomidine will not be changed. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure and sedation will continue at the discretion of the anesthesiologist. |
| BG003 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | 71 participants were enrolled but only 55 completed the study. Analysis was only performed on these 55 participants. | Count of Participants | Participants |
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| Age, Continuous | 71 participants were enrolled but only 55 completed the study. Analysis was only performed on these 55 participants. | Mean | Full Range | years |
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| Sex: Female, Male | 71 participants were enrolled but only 55 completed the study. Analysis was only performed on these 55 participants. | Count of Participants | Participants |
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| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
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| Region of Enrollment | 71 participants were enrolled but only 55 completed the study. Analysis was only performed on these 55 participants. | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Dosage/Consumption | Dosage and consumption of dexmedetomidine infusion | Patients who completed the study and received a dexmedetomidine infusion | Posted | Mean | 95% Confidence Interval | mcg/kg/min | Prior to beginning the MRI and throughout the MRI scan - approximately one hour. |
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| Primary | Incidence of Patient Movement and MRI Interruption | If patient moved during their MRI and caused an interruption of the scan. | Posted | Number | patients | During the MRI scan, until completion, approximately one hour. |
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| Primary | Incidence of Adverse Events | arterial desaturation, airway obstruction, hypotension and bradycardia | Posted | Number | 95% Confidence Interval | incidents | From the time the medication is initiated just (5 minutes) prior to the MRI scan and during the MRI scan and immediately during recovery - approximately one hour and twenty minutes in total. |
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| Primary | Case Times | Number of minutes from the start of sedation medication administration to the time the patient is adequately sedated for the MRI scan, | Posted | Median | Inter-Quartile Range | minutes | Timeframe immediately before the MRI scan while sedation medication is administered - approximately 10 minutes |
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| Secondary | Incidence of Technique Failure | lack of adequate sedation for MRI scan in spite of the sedation as described above | Posted | Number | incidents | During the MRI scan until completion - approximately one hour |
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| Secondary | Sedation Infusion Time | The number of minutes that the patient was receiving dexmedetomidine infusion | Patients who completed the study and received a dexmedetomidine infusion | Posted | Median | Inter-Quartile Range | minutes | For the duration of the MRI scan - approximately one hour |
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| Secondary | Case Duration | total number of minutes in the MRI scanner, | Posted | Mean | Standard Deviation | minutes | Duration of the MRI scan - approximately one hour |
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| Secondary | Recovery Time | number of minutes in the recovery area until the patient appeared awake (eye opening), | Posted | Mean | Standard Deviation | minutes | from completion of the MRI scan until prepared for discharge - approximately 90 minutes |
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During the MRI scan and recovery - then for one week after the date of discharge.
Enrollment has been completed for all three arms of this study. There are no adverse events to report.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Dexmedetomidine (High)-Propofol Arm | First, the investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. Next, the investigators will begin an infusion at 1mcg/kg/hour. At the 5 minute point, propofol will be given (2mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure. | 0 | 13 | 0 | 13 | 0 | 13 |
| EG001 | Dexmedetomidine (Low)-Propofol Arm | First, the investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. Next, the investigators will begin an infusion at 0.5 mcg/kg/hour. At the 5 minute point, propofol will be given (2mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure. | 0 | 14 | 0 | 14 | 0 | 14 |
| EG002 | Dexmedetomidine (Bolus Only) -Propofol Arm | First, the investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. At the 5 minute point, propofol will be given (2mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure. | 0 | 28 | 0 | 28 | 0 | 28 |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Joseph P. Cravero | Boston Children's Hospital | 617-355-4292 | Joseph.Cravero@childrens.harvard.edu |
| Oct 18, 2021 |
| Prot_SAP_001.pdf |
| ID | Term |
|---|---|
| D004827 | Epilepsy |
| D002547 | Cerebral Palsy |
| D007859 | Learning Disabilities |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D001925 | Brain Damage, Chronic |
| D003147 | Communication Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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| OG002 | Dexmedetomidine (Bolus Only)-Propofol Arm | First, the investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. At the 5 minute point, propofol will be given (2mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure. |
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| OG002 | Dexmedetomidine (Bolus Only)-Propofol Arm | First, the investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. At the 5 minute point, propofol will be given (2mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure. |
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| OG002 | Dexmedetomidine (Bolus Only)-Propofol Arm | First, the investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. At the 5 minute point, propofol will be given (2mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure. |
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| OG002 | Dexmedetomidine (Bolus Only)-Propofol Arm | First, the investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. At the 5 minute point, propofol will be given (2mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine whether or not the child is in an adequate state to begin the MRI scan. If the sedative effect of the dexmedetomidine-propofol does not produce a sufficiently sedated state within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure. |
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| OG002 | Dexmedetomidine (Bolus Only)-Propofol Arm | The investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. At the 5 minutes, propofol will be given (2mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine if the child is in an adequate state to begin the MRI scan. If the child is not sufficiently sedated within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure and sedation will continue at the discretion of the anesthesiologist. |
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| OG002 | Dexmedetomidine (Bolus Only)-Propofol Arm | The investigators will administer dexmedetomidine 1mcg/kg over 5 minutes. At the 5 minutes, propofol will be given (2mg/kg bolus followed by 100mcg/kg/min infusion). The attending clinician will determine if the child is in an adequate state to begin the MRI scan. If the child is not sufficiently sedated within 10 minutes, a repeat bolus of propofol 2mg/kg will be administered. The dose will be repeated if the child is not adequately sedated in 2 more minutes. At this time infusion rate of propofol will be increased to 200 mcg/kg/minute. If the child is not sedated in 5 more minutes, the outcome will be recorded as a technique failure and sedation will continue at the discretion of the anesthesiologist. |
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