Comparison of different propofol target-controlled infusion concentrations in children with autism spectrum disorder undergoing magnetic resonance imaging.

This study looked at two different amounts of a sedation medicine (propofol) used to help autistic children stay still during brain scans. Both amounts worked well to sedate the children, but the lower amount was safer - it caused fewer breathing and heart problems, children woke up faster, and needed less medicine overall. The researchers recommend using the lower amount for brain scans in autistic children.

This randomized controlled trial compared two propofol target-controlled infusion concentrations (2.0 µg/mL vs 2.5 µg/mL) for sedating 120 preschool children with autism spectrum disorder during functional MRI. Both concentrations achieved high sedation success rates (91.67% vs 96.67%), with no significant difference. However, the lower concentration (2.0 µg/mL) demonstrated superior safety and practical advantages: more stable blood pressure, fewer respiratory and circulatory complications, significantly lower propofol maintenance doses, shorter recovery times, and smoother emergence from sedation. The study concluded that 2.0 µg/mL propofol TCI is the preferred concentration for fMRI sedation in children with ASD.

Clinicians should consider using 2.0 µg/mL propofol TCI concentration for fMRI sedation in preschool children with ASD. This concentration provides equivalent sedation efficacy while offering superior safety, reduced drug requirements, and improved recovery profiles compared to higher concentrations.

Single-center study limiting generalizability. Study focused only on preschool children with ASD, so findings may not apply to other age groups or neurotypical children. Long-term outcomes and potential effects on neurodevelopment were not assessed.

This study aimed to compare the safety and efficacy of two target-controlled infusion (TCI) concentrations of propofol for sedation during cranial functional magnetic resonance imaging (fMRI) in children with autism spectrum disorder (ASD). A total of 120 preschool children with ASD scheduled for fMRI between January 2021 and July 2023 were enrolled and randomized into two groups: a low-concentration group (2.0 µg/mL, n = 60) and a high-concentration group (2.5 µg/mL, n = 60). Vital signs, sedation parameters, and adverse events were meticulously recorded to assess outcomes. The first-time sedation success rate was high and comparable between the 2.0 group and the 2.5 group (91.67% vs. 96.67%, p = 0.439).

However, the 2.5 group demonstrated a significant reduction in mean systolic blood pressure (p = 0.001). While the overall incidence of adverse events was not significantly different, respiratory and circulatory depression events were less frequent in the 2.0 group. Furthermore, the 2.0 group required a significantly lower maintenance dose of propofol (p < 0.001), experienced a shorter recovery time (p = 0.042), and had a smoother emergence profile. In conclusion, a propofol TCI concentration of 2.0 µg/mL is effective and safe for fMRI sedation in children with ASD and is clinically preferable to 2.5 µg/mL due to a more stable hemodynamic profile, reduced drug requirement, and faster, smoother recovery.Trial registration: ChiCTR2100050071.