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Effects of dexmedetomidine sedation for magnetic resonance imaging in children: a systematic review and meta-analysis



Pediatric sedation is commonly required to obtain high-quality images in magnetic resonance imaging (MRI). We performed a systematic review and meta-analysis to assess the effects of dexmedetomidine sedation for MRI in children.


A systematic review was conducted to find all randomized controlled trials concerning dexmedetomidine sedation for MRI in children. We searched databases using the Ovid platform in the Cochrane Controlled Trials Register, MEDLINE, and EMBASE. This study was registered in the PROSPERO database: CRD42020198368.


Seven studies and 753 participants were included. Dexmedetomidine sedation showed a significantly delayed onset time [weighted mean differences (WMD) = 8.13 min, 95% confidence interval (CI) 4.64 to 11.63, I2 = 98%] and recovery time (WMD = 5.22 min, 95% CI 0.35 to 10.09, I2 = 92%) compared to propofol, ketamine, and midazolam sedation. There was no difference in quality of sedation [risk ratio (RR) = 1.25, 95% CI 0.92 to 1.69, I2 = 89%], or incidence of sedation failure (RR = 1.39, 95% CI 0.53 to 3.66, I2 = 83%) between groups. Although a significantly decreased heart rate (WMD = − 17.34 beats/minute, 95% CI − 22.42 to − 12.26, I2 = 96%) was observed, bradycardia that required treatment was not increased (RR = 8.00, 95% CI 1.02 to 62.64, I2 = 0%). Dexmedetomidine sedation had a lower incidence of desaturation events (RR = 0.42, 95% CI 0.20 to 0.86, I2 = 4%). However, there was no difference in incidence of postoperative vomiting (RR = 0.42, 95% CI 0.15 to 1.17, I2 = 17%) between groups.


Dexmedetomidine sedation provided a similar sedation quality with a reduced incidence of desaturation events. However, the delayed onset and recovery times were drawbacks. The clinical significance of bradycardia is considered to be low. GRADE assessment revealed the quality of the evidence in this meta-analysis ranged from very low to moderate.

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  1. 1.

    Schulte-Uentrop L, Goepfert MS. Anaesthesia or sedation for MRI in children. Curr Opin Anaesthesiol. 2010;23(4):513–7.

    Article  Google Scholar 

  2. 2.

    Ahmad R, Hu HH, Krishnamurthy R, Krishnamurthy R. Reducing sedation for pediatric body MRI using accelerated and abbreviated imaging protocols. Pediatr Radiol. 2018;48(1):37–49.

    Article  Google Scholar 

  3. 3.

    Hallowell LM, Stewart SE, de Amorim ESCT, Ditchfield MR. Reviewing the process of preparing children for MRI. Pediatr Radiol. 2008;38(3):271–9.

    Article  Google Scholar 

  4. 4.

    Arthurs OJ, Sury M. Anaesthesia or sedation for paediatric MRI: advantages and disadvantages. Curr Opin Anaesthesiol. 2013;26(4):489–94.

    CAS  Article  Google Scholar 

  5. 5.

    Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg. 2000;90(3):699–705.

    CAS  Article  Google Scholar 

  6. 6.

    Chrysostomou C, Schmitt CG. Dexmedetomidine: sedation, analgesia and beyond. Expert Opin Drug Metab Toxicol. 2008;4(5):619–27.

    CAS  Article  Google Scholar 

  7. 7.

    Arain SR, Ebert TJ. The efficacy, side effects, and recovery characteristics of dexmedetomidine versus propofol when used for intraoperative sedation. Anesthesia and Analgesia. 2002;95(2):461–6, table of contents.

  8. 8.

    Bloor BC, Ward DS, Belleville JP, Maze M. Effects of intravenous dexmedetomidine in humans II hemodynamic changes. Anesthesiology. 1992;77(6):1134–42.

    CAS  Article  Google Scholar 

  9. 9.

    Zhou Q, Shen L, Zhang X, Li J, Tang Y. Dexmedetomidine versus propofol on the sedation of pediatric patients during magnetic resonance imaging (MRI) scanning: a meta-analysis of current studies. Oncotarget. 2017;8(60):102468–73.

    Article  Google Scholar 

  10. 10.

    Fang H, Yang L, Wang X, Zhu H. Clinical efficacy of dexmedetomidine versus propofol in children undergoing magnetic resonance imaging: a meta-analysis. Int J Clin Exp Med. 2015;8(8):11881–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration; 2011.

  12. 12.

    Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ (Clinical research ed). 2003;327(7414):557–60.

    Article  Google Scholar 

  13. 13.

    Yang Z, Song G, Hu W, Dang X, Haijuan G, Yu J. Pharmacological analysis of dexmedetomidine hydrochloride in pediatric anesthesia during magnetic resonance imaging. Pakistan J Pharmac Sci. 2018;31(5(Special)):2209–14.

  14. 14.

    Kamal K, Asthana U, Bansal T, Dureja J, Ahlawat G, Kapoor S. Evaluation of efficacy of dexmedetomidine versus propofol for sedation in children undergoing magnetic resonance imaging. Saudi J Anaesth. 2017;11(2):163–8.

    Article  Google Scholar 

  15. 15.

    Eldeek AM, Elfawal SM, Allam MG. Sedation in children undergoing magnetic resonance imaging comparative study between dexmedetomidine and ketamine. Egyptian Journal of Anaesthesia. 2016;32(3):263–8.

    Article  Google Scholar 

  16. 16.

    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;24(8):813–8.

    Article  Google Scholar 

  17. 17.

    Tammam TF. Comparison of the efficacy of dexmedetomidine, ketamine, and a mixture of both for pediatric MRI sedation. Egyptian Journal of Anaesthesia. 2013;29(3):241–6.

    Article  Google Scholar 

  18. 18.

    Koroglu A, Teksan H, Sagir O, Yucel A, Toprak HI, Ersoy OM. A comparison of the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging. Anesthesia & Analgesia. 2006;103(1):63–7, table of contents.

  19. 19.

    Koroglu A, Demirbilek S, Teksan H, Sagir O, But AK, Ersoy MO. Sedative, haemodynamic and respiratory effects of dexmedetomidine in children undergoing magnetic resonance imaging examination: preliminary results. Br J Anaesth. 2005;94(6):821–4.

    CAS  Article  Google Scholar 

  20. 20.

    Campbell K, Torres L, Stayer S. Anesthesia and sedation outside the operating room. Anesthesiol Clin. 2014;32(1):25–43.

    Article  Google Scholar 

  21. 21.

    Krauss B, Green SM. Procedural sedation and analgesia in children. Lancet (London, England). 2006;367(9512):766–80.

    CAS  Article  Google Scholar 

  22. 22.

    Roback MG, Carlson DW, Babl FE, Kennedy RM. Update on pharmacological management of procedural sedation for children. Curr Opin Anaesthesiol. 2016;29(Suppl 1):S21-35.

    CAS  Article  Google Scholar 

  23. 23.

    Mason KP, Zurakowski D, Zgleszewski SE, Robson CD, Carrier M, Hickey PR, Dinardo JA. High dose dexmedetomidine as the sole sedative for pediatric MRI. Paediatr Anaesth. 2008;18(5):403–11.

    Article  Google Scholar 

  24. 24.

    Mason KP, Lönnqvist PA. Bradycardia in perspective-not all reductions in heart rate need immediate intervention. Paediatr Anaesth. 2015;25(1):44–51.

    Article  Google Scholar 

  25. 25.

    Mason KP, Zgleszewski SE, Prescilla R, Fontaine PJ, Zurakowski D. Hemodynamic effects of dexmedetomidine sedation for CT imaging studies. Paediatr Anaesth. 2008;18(5):393–402.

    Article  Google Scholar 

  26. 26.

    Srinivasan M, Turmelle M, Depalma LM, Mao J, Carlson DW. Procedural sedation for diagnostic imaging in children by pediatric hospitalists using propofol: analysis of the nature, frequency, and predictors of adverse events and interventions. J Pediatr. 2012;160(5):801-6.e1.

    Article  Google Scholar 

  27. 27.

    Mallory MD, Baxter AL, Yanosky DJ, Cravero JP. Emergency physician-administered propofol sedation: a report on 25,433 sedations from the pediatric sedation research consortium. Ann Emerg Med. 2011;57(5):462-8.e1.

    Article  Google Scholar 

  28. 28.

    Cravero JP, Beach ML, Blike GT, Gallagher SM, Hertzog JH. The incidence and nature of adverse events during pediatric sedation/anesthesia with propofol for procedures outside the operating room: a report from the Pediatric Sedation Research Consortium. Anesth Analg. 2009;108(3):795–804.

    CAS  Article  Google Scholar 

  29. 29.

    Aghajanian GK, VanderMaelen CP. Alpha 2-adrenoceptor-mediated hyperpolarization of locus coeruleus neurons: intracellular studies in vivo. Science (New York, NY). 1982;215(4538):1394–6.

    CAS  Article  Google Scholar 

  30. 30.

    Hsu YW, Cortinez LI, Robertson KM, Keifer JC, Sum-Ping ST, Moretti EW, Young CC, Wright DR, Macleod DB, Somma J. Dexmedetomidine pharmacodynamics: part I: crossover comparison of the respiratory effects of dexmedetomidine and remifentanil in healthy volunteers. Anesthesiology. 2004;101(5):1066–76.

    CAS  Article  Google Scholar 

  31. 31.

    Sriganesh K, Saini J, Theerth K, Venkataramaiah S. Airway dimensions in children with neurological disabilities during dexmedetomidine and propofol sedation for magnetic resonance imaging study. Turkish J Anaesthesiol Reanimat. 2018;46(3):214–21.

    Article  Google Scholar 

  32. 32.

    Mahmoud M, Mason KP. Dexmedetomidine: review, update, and future considerations of paediatric perioperative and periprocedural applications and limitations. Br J Anaesth. 2015;115(2):171–82.

    CAS  Article  Google Scholar 

  33. 33.

    Whittington RA, Virág L. Dexmedetomidine-induced decreases in accumbal dopamine in the rat are partly mediated via the locus coeruleus. Anesth Analg. 2006;102(2):448–55.

    CAS  Article  Google Scholar 

  34. 34.

    Jin S, Liang DD, Chen C, Zhang M, Wang J. Dexmedetomidine prevent postoperative nausea and vomiting on patients during general anesthesia: A PRISMA-compliant meta analysis of randomized controlled trials. Medicine. 2017;96(1):e5770.

    CAS  Article  Google Scholar 

  35. 35.

    Massad IM, Mohsen WA, Basha AS, Al-Zaben KR, Al-Mustafa MM, Alghanem SM. A balanced anesthesia with dexmedetomidine decreases postoperative nausea and vomiting after laparoscopic surgery. Saudi Med J. 2009;30(12):1537–41.

    PubMed  Google Scholar 

  36. 36.

    Kjaergard LL, Villumsen J, Gluud C. Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann Intern Med. 2001;135(11):982–9.

    CAS  Article  Google Scholar 

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Correspondence to Kyu Nam Kim.

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This study was not supported by external funding and the authors have no conflict of interest to disclose.

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Kim, J.Y., Kim, K.N., Kim, D.W. et al. Effects of dexmedetomidine sedation for magnetic resonance imaging in children: a systematic review and meta-analysis. J Anesth 35, 525–535 (2021).

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  • Dexmedetomidine
  • Hypnotics and sedatives
  • Magnetic resonance imaging
  • Child