A local study published in the September 2007 issue of Pediatrics suggests that the use of propofol to induce sedation in children for radiological services is more effective and has fewer side effects than pentobarbital which is still used at several children's hospitals and pediatric facilities nationwide.

Jay Pershad, M.D. of Le Bonheur Children's Medical Center and University of Tennessee Health Science Center was the lead author of the study. Co-authors included Jim Wan, Ph.D. of the Department of Preventive Medicine at UTHSC and Doralina L. Anghelescu, M.D. of the Division of Anesthesiology at St. Jude Children's Research Hospital.

The study was conducted in collaboration with hospital administration and Pediatric Sedation Specialists, PC, the group that provides anesthesiology services at Le Bonheur. The emphasis was to improve quality and efficiency of radiology services. Dr. Pershad enrolled 60 patients between the ages of 1-17 years, who required intravenous sedation for elective cranial MRI.

The group looked at propofol and pentobarbital, which are frequently used to induce deep sedation in children when undergoing an MRI. Pershad says to his knowledge, these two drugs had not been compared in a randomized, controlled trial. Investigators looked at the recovery time of children after deep sedation with single-agent propofol and a pentobarbital-based regimen for MRI. They also considered safety and efficacy of the two medications.

According to Pershad, pentobarbital has been and is still being used in several pediatric facilities around the country for radiology sedations. It has a long track record of safety and efficacy. Propofol was introduced when Pediatric Sedation Specialists, PC, began providing sedation services at Le Bonheur in 2005.

"The results of our study suggest that patients who receive propofol have shorter MRI times from start to finish, and scored higher at their follow up patient satisfaction surveys. There were no differences in the quality of images or number of repeat sequences," Pershad said. "This information is extremely valuable as we open a second MRI scanner at Le Bonheur. Efficiency and through put times in the MRI suite will be key determinants of patient satisfaction and profitability."

Pershad is an associate professor of pediatrics, co-director of the Pediatric Emergency Medicine Fellowship Training program and a partner with Pediatric Sedation Specialists, PC.

"Administration of propofol requires greater skill and vigilance for airway related complications. We have extensive experience with propofol for procedural sedation both in the Emergency Department and in radiology, with a very low rate of complications or sedation failures."

Pediatrics is the flagship journal of the American Academy of Pediatrics. The journal has a subscriber base of over 63,000 readers that includes an international audience of 15,000. It has the highest impact factor (4.2) among all pediatric journals.