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Background and Aims: Inhalational technique is used to induce anaesthesia in children without intravenous access. We aimed to determine the median effective dose (ED50) of intranasal dexmedetomidine to ensure satisfactory mask acceptance during inhalation induction in children with retinoblastoma undergoing examination under anaesthesia. Methods: A prospective sequential allocation study was conducted in children aged 1-60 months divided into Group A (1-18 months) and Group B (18-60 months). Children were administered dexmedetomidine intranasally as premedication. Sedation was assessed using the modified Observer Assessment of Alertness and Sedation Scale until induction. Successful mask acceptance was defined as a cooperative or asleep child during inhalational induction. The starting dose of dexmedetomidine was 1 mg/kg. The next dose varied by 0.2 mg/kg depending on the outcome of this case. According to the Dixon up-and-down method, the mean of midpoints of the failure-success sequence was calculated to obtain the ED50 values. Results: The ED50 of intranasal dexmedetomidine for satisfactory mask acceptance was 0.7 mg/kg (95% confidence interval [CI]: 0.54-0.86) in Group A (n = 23) and 0.96 mg/kg (95% CI: 0.83-1.08) in Group B (n = 25) (P = 0.020). The mean (standard deviation) duration of anaesthesia was 33.5 (14.9) minutes in group A versus 23.5 (8.48) minutes in Group B (P = 0.007). Conclusion: ED50 was lower in children younger than 18 months than in older children. There was no difference in the time to discharge from the post-anaesthesia care unit despite the procedure being longer in smaller children. [ABSTRACT FROM AUTHOR]

Objective: Our study compared the discharge time after pediatric magnetic resonance imaging (MRI) following sedation with propofol infusion dose of 100, 75 and 50 mcg/ kg/min given after a bolus dose of ketamine and propofol. Materials and Methods: One hundred children of American Society of Anesthesiologists status 1/2, aged 6 months to 8 years, scheduled for elective MRI were enrolled and randomized to three groups to receive propofol infusion of 100, 75 or 50 mcg/kg/min (Groups A, B, and C, respectively). After premedicating children with midazolam 0.05 mg/kg intravenous (i.v.), sedation was induced with bolus dose of ketamine and propofol (1 mg/kg each) and the propofol infusion was connected. During the scan, heart rate, noninvasive blood pressure, respiratory rate, and oxygen saturation were monitored. Results: The primary outcome that is, discharge time was shortest for Group C (44.06 ± 18.64 min) and longest for Group A (60.00 ± 18.66 min), the difference being statistically and clinically significant. The secondary outcomes that is, additional propofol boluses, scan quality and awakening time were comparable for the three groups. The systolic blood pressure at 20, 25 and 30 min was significantly lower in Groups A and B compared with Group C. The incidence of sedation related adverse events was highest in Group A and least in Group C. Conclusion: After a bolus dose of ketamine and propofol (1 mg/ kg each), propofol infusion of 50 mcg/kg/min provided sedation with shortest discharge time for MRI in children premedicated with midazolam 0.05 mg/kg i.v. It also enabled stable hemodynamics with less adverse events. [ABSTRACT FROM AUTHOR]