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Effects of IV Pentobarbital With and Without Fentanyl on End-Tidal Carbon Dioxide Levels During Deep Sedation of Pediatric Patients Undergoing MRI

¹ Department of Radiology, Children's Hospital, 300 Longwood Ave., Harvard Medical School, Boston, MA 02115.
² Departments of Biostatistics and Orthopaedic Surgery, Children's Hospital, Harvard Medical School, Boston, MA 02115.
³ Department of Anesthesia, Children's Hospital, Harvard Medical School, Boston, MA 02115.

OBJECTIVE. IV pentobarbital is used in radiology departments for sedating pediatric patients undergoing diagnostic imaging. To our knowledge, no published studies have documented end-tidal carbon dioxide levels during sedation with IV pentobarbital. The purpose of this prospective study was to determine the effects of different doses of IV pentobarbital with or without fentanyl on end-tidal carbon dioxide levels during deep sedation of pediatric patients undergoing MRI.

SUBJECTS AND METHODS. One hundred sixty-five patients (70 girls, 95 boys) having a mean age of 3.4 years received IV pentobarbital sedation with or without fentanyl for undergoing MRI from January through March 2002. Each child was sedated with 2–6 mg/kg of body weight of IV pentobarbital and an additional 1–3 µg/kg of fentanyl if needed. After the administration of sedation, a 28-ft (8.5 m) nasal cannula with capnography capability was applied to each patient, and capnogram tracings and values were recorded every 5 min.

RESULTS. Mean values of end-tidal carbon dioxide were between 37 and 42 mm Hg during 60 min of sedation for both groups. When IV pentobarbital was used alone, no significant difference was seen between patients who received 3–5 mg of pentobarbital and those who received more than 5 mg (p = 0.97, F test).

CONCLUSION. End-tidal carbon dioxide levels remain within normal clinical range during sedation with IV pentobarbital with or without fentanyl. Our sedation protocol produced no significant deviations from normal respiratory parameters.

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