Comparing Safety and Efficacy of Dexmedetomidine and Propofol

This is a prospective, open label randomized study. The purpose of this study is to compare propofol with dexmedetomidine for pediatric monitored anesthesia care for MRI, specifically identifying important patient demographics and looking at important outcomes including adverse events.

Patients will be randomized to either arm of the study. Throughout the sedation and recovery period, all study patients will have careful, routine documentation of hemodynamics (blood pressure, heart rate, plus oximeter, respiratory rate) as well as sedation depth. Patients will remain in recovery room until they have maintained discharge criteria for 30 minutes.

• Drug: Dexmedetomidine
  An initial bolus of 2 mcg/kg of dexmedetomidine will be administered over 10 minutes. This bolus can be repeated up to 2 times if sedation conditions are not achieved. Once successful sedation has been achieved, a 1.5 mcg/kg/hr infusion is initiated until the MRI is complete.
  Other Name: Precedex
• Drug: Propofol
  An initial bolus of 1mg/kg of propofol will be administered over 1 minute. This bolus can be repeated up to 2 times if sedation conditions are not achieved. Once successful sedation has been achieved, a propofol infusion of 125 mcg/kg/min is initiated until the MRI is complete.
  Other Name: Diprivan

• Active Comparator: Dexmedetomidine Group
  Intervention: Drug: Dexmedetomidine
• Active Comparator: Propofol Group
  Intervention: Drug: Propofol

Inclusion Criteria:

• Patient is 3 - 11 years
• Patient is scheduled for MRI at Children's Hospital Boston.
• Patient meets criteria to receive either dexmedetomidine or propofol sedation
• Patient's guardian provides written consent

Exclusion Criteria:

• Patient does not meet established sedation criteria
• Patient has history of allergy, intolerance, or reaction to dexmedetomidine or propofol or hypersensitivity
• Patient has current, repaired, or risk for Moya-Moya disease
• Patient has had a stroke within the past six months
• Patient has uncontrolled hypertension
• Patient currently uses beta antagonist, alpha 2 agonist or calcium blocker
• Known soy, Lecithin, or egg allergy