Efficacy and safety of rectal thiopental: sedation for children undergoing computed tomography and magnetic resonance imaging

Abstract

Purpose: We evaluated the clinical safety, effectiveness, efficiency and potential side effects of rectally administered thiopental in 30 children undergoing computed tomography (CT) and magnetic resonance imaging (MRI).

Methods: The doses of thiopental used were 50 mg/kg for infants under 6 months of age, 35 mg/kg for infants between 6 and 12 months of age and 25 mg/kg for older children. After administration of the sedative, oxygen saturation was continuously monitored and vital signs were recorded every 20 min during the imaging procedure and then every 20 min until discharge.

Results: Successful sedation and adequate imaging were obtained in 29 of 30 (96.7%) patients. Respiratory depression was not observed in any patient. However, oxygen saturation dropped below 90% transiently (to 88%) in three patients (10.0%) and this was immediately corrected by repositioning the child's neck to open the upper airway. All successfully sedated patients were asleep within 15 min (mean +/- SD 7.3 +/- 2.7 min) and sedation was sufficient for at least 30 min. Prolonged sedation was observed in two patients.

Conclusions: We believe that rectal thiopental is a safe, effective and efficient form of sedation for pediatric imaging.