Adverse events and sedation characteristics of propofol and dexmedetomidine during magnetic resonance imaging: An observational study in neuropsychiatric population

Abstract

Objectives: Propofol and dexmedetomidine are the most commonly used sedative drugs during magnetic resonance imaging (MRI) studies. However, data regarding peri-procedural adverse events, and the profile of these drugs concerning the quality of sedation, imaging, and recovery is limited in neurological and psychiatric populations. This study aimed to compare adverse events and sedation characteristics of propofol and dexmedetomidine during MRI studies in patients with neurological and psychiatric illnesses. Materials and Methods: This prospective observational study was conducted between March 2020 and September 2021 after the Ethics Committee’s approval and informed consent. Patients of all ages and genders undergoing elective MRI studies for neurological, neurosurgical, or psychiatric illness under sedation with either dexmedetomidine or propofol infusion were included in the study. Results: The patients in the dexmedetomidine group were older, had higher body mass index, and had more pre-procedure risk factors than the propofol group. Pre-medication use (midazolam or ketamine) was more in the propofol group. There was no difference in respiratory adverse events, but cardiovascular events (bradycardia and hypotension) were more with dexmedetomidine. There was no difference in the quality of sedation (patient movement, image quality, and need for repeating the imaging sequence). Recovery time from anesthesia was faster, and Aldrete score and Observer Assessment of Alertness/Sedation Scale scores in the post-anesthesia care unit were higher with propofol. Conclusion: Cardiovascular but not respiratory adverse events were more with dexmedetomidine, recovery profile was better with propofol, and both the drugs were similar regarding the quality of sedation and images in neurological and psychiatric patients undergoing MRI study.