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Inadequate sedation leads to both cancellation of studies or poor images due to motion artifact.

delay in diagnosis or treatment

nursing time away from the unit

slows work flow in the MRI/CT suite

Analgesia but no sedation

Often used for sedation or seizure control but are associated with apnea and hypotension.

Associated with increased risk of death, severe IVH, PVL and poor neurodevelopmental outcomes in general.

side effects include respiratory depression, hypotension, tolerance and dependence.

Lifelong suppression of hippocampal synaptic plasticity when given during synaptogenesis in rat studies. (affecting LTP and learning ability)

Old drug, but still the drug of choice when sedation for non-painful procedures is needed

Pros: well tolerated and 80-90% of infants achieve adequate sedation

Cons: variable time to work, leaves babies drowsy for unpredictably long periods of time, and... there is no antidote.

50 mg/kg initial dose. If sedation is not adequate in 30-60 minutes, an additional 50 mg/kg may be given

75 mg/kg is more typical with a maximum of 100 mg/kg.

Dose may be given PO or per rectum

May be given 30 minutes to an hour before the procedure. Or even longer!

Feeding and swaddling are always helpful

Conscious Sedation for the

Neonate needing MRI or CT Scanning

Dosing Options

Chloral hydrate

Opioids

Morphine

Fentanyl

Benzodiazepines

Midazolam

Lorazepam

Barbiturates

Phenobarbital

Pentobarbital

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