Methohexital Sedation of Children Undergoing CT Scan

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Abstract
Computed tomography (CT) scans are performed frequently for the evaluation of central nervous system (CNS) pathology. The patient needs to remain relatively motionless for the duration of the scan, which is usually 15--30 min. Movement can produce artifact, which will make the scan nondiagnostic. Infants and young children are often unable to remain still for this period of time and hence require sedation or general anesthesia to maintain a motionless state. Delays caused by uncooperative children, or by prolonged induction of anesthesia represent a scheduling and economic burden to the radiology department as well as to the parents (1). In addition, many of these patients have repeated scans performed as outpatients, requiring the return to preanesthetic state as quickly as possible. We evaluated the use of intramuscular methohexital for sedation of children undergoing CT scans of the head because complications such as respiratory depression, significant CNS depression, respiratory arrest (2), and failure to achieve a motionless state (3,4) are associated with other methods of sedation. Various concentrations of methohexital from 2 to 5% have been successfully used for sedation, although a 5% solution has been found to be less effective (5) than more dilute solutions. It is advantageous to use as small a volume as possible when employing the intramuscular route; therefore, we chose to compare two concentrations, 3.5 and 5%, of methohexital while giving the same dose per kilogram body weight to children undergoing CT scans of the head.

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