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Published online before print October 22, 2001, 10.1148/radiol.2213010236
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(Radiology. 2001;221:760-762.)
© RSNA, 2001

Pediatric Imaging

Pediatric Imaging: Sedation with an Injection Formulation Modified for Rectal Administration1

Mai T. Nguyen, MD, S. Bruce Greenberg, MD, Kari R. Fitzhugh, RN and Charles M. Glasier, MD

1 From the Department of Pediatric Radiology, Arkansas Children’s Hospital, 800 Marshall St, Little Rock, AR 72202. From the 2000 RSNA scientific assembly. Received January 4, 2001; revision requested February 14; revision received June 1; accepted June 7. Address correspondence to S.B.G. (e-mail: greenbergsbruce@uams.edu).

PURPOSE: To determine if rectal sedation with thiopental sodium produced for intravenous administration provides safe and effective sedation for children undergoing diagnostic imaging.

MATERIALS AND METHODS: Five hundred twenty-five consecutive children (mean age, 2.7 years ± 2.2 [SD]) underwent magnetic resonance imaging (n = 425), computed tomography (n = 89), and nuclear medicine (n = 11) examinations after rectal administration of thiopental sodium injection solution. The solution was prepared from thiopental sodium powder mixed with sterile water to create a concentration of 100 mg/mL. The dose ranged from 25 to 40 mg per kilogram of body weight, with a total dose limit of 1.5 g. The percentages of successful sedations and adverse reactions were evaluated on the basis of data collected at the time of the sedation.

RESULTS: Sedation was successful in 504 (96%) children. Ten (2%) children experienced desaturation, but only three of the 10 experienced sedation failure. All cases of desaturation were treated successfully with head repositioning, administration of supplemental oxygen, or both. No children experienced vomiting, acute rectal irritation, paradoxical hyperactivity, or prolonged sedation.

CONCLUSION: Thiopental sodium sedation for pediatric imaging, with use of a rectal solution prepared from thiopental sodium preparation for intravenous injection, is safe and effective.

Index terms: Computed tomography (CT), in infants and children • Magnetic resonance (MR), in infants and children • Radionuclide imaging