Sedation Management On Magnetic Resonance Cholangiopancreatography In Infant With Biliary Atresia

Objective:To explore the methods and management points for Magnetic Resonance Cholangiopancreatography（MRCP）in infants with biliary atresia（BA）.Methods:Retrospective analysis of infants with BA who undergoing MRCP in the Sedation Center of Children’s Hospital of Chongqing Medical University from January 2019 to June 2019;collecting the general information of infants,method of sedation,success rate of primary sedation and rescue drug administration;comparing the changes in vital signs during the peri-sedation period:heart rate（HR）and blood oxygen saturation（SpO₂）between the before sedation time（T₀）,the beginning of inspection time（T₁）,10min into the inspection（T₂）,the end of inspection time（T₃）and the time when they wake up（T₄）;record and count the induction time,examination time,recovery time and adverse events.Results:A total of 94 cases of BA infants were collected,median（interquartile range）patient age was 13.5（7.0-34.0）weeks,weight was 4.5（3.9-6.0）kg,21 infants（21.4%）with ASA III and above.All infants were sedated by 2μg/kg intranasal dexmedetomidine combination with sevoflurane inhalation and successfully completed the examination.The success rate of primary sedation was 97.9%（95%CI:94.9%-100%）,just 2patients need for rescue drug administration.All patients’vital signs were stable around the sedation period,compared with T₀,the T₁-T₄ moment heart rate slowed down（P<0.05）,and T₁ moment heart rate was the lowest,T₂-T₄ moment heart rate（HR）gradually increased compared with the previous moment;compared with T₀,T₂,T₃,T₄,the T₁ moment blood oxygen saturation（SpO₂）was increased（P<0.05）;mean induction time was 19.8±5.0 min,mean examination time was 22.3±6.0 min,mean recovery time was 14.6±7.3 min and no adverse events was been recorded.Conclusion:Infants with BA are very small in age and have complex comorbidities,requiring higher sedation management for MRCP examination.2μg/kg intranasal dexmedetomidine combined with sevoflurane inhalation have short induction time,high primary success rate,good quality of awakening,stable vital signs and low incidence of adverse events during the peri-sedation period.