Combination of Dexmedetomidine and Ketamine for Magnetic Resonance Imaging Sedation

Conclusions: The efficacy of DEX–KET sedation was comparable to that of midazolam for MRI examination. DEX–KET was related to shorter scan time and lower occurrence of complications compared to midazolam. Introduction Neurocritically ill patients often require brain magnetic resonance imaging (MRI) in addition to conventional neurological evaluations. Brain MRI can reveal structural lesions with a high sensitivity due to its excellent spatial resolution and enhanced soft tissue contrast (1–3). To acquire MRI images, patients' cooperation is imperative. However, keeping patients with brain dysfunction immobilized in a dark, noisy MRI scanner is challenging and may require administration of sedative agents to ensure motion-artifact-free images (4–8). The use of sedative agents may not always guarantee patients' cooperation and it may even exert side effects. In addition, prolonged MRI duration due to uncooperative patients may increase the occurrence of adverse events due to withheld care management upon absence from the neurological intensive care unit (neuro-ICU) (9). Therefore, a proper sedation regimen is crucial to manage neurocritically ill patients undergoing MRI. Dexmedetomidine, an α-2 adrenoreceptor agonist, has been widely used in intensive care units due to its beneficial effects in conscious sedation, anxiety relief, and pain control, associated with minimal or absent respiratory depression (10). Howe...
Source: Frontiers in Neurology - Category: Neurology Source Type: research