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Ismail MIA, Aldmour A, Al-Husinat L, El-Gendy GA, Mansour SW. A Comparison of the Use of Propofol versus Midazolam for Pediatric Magnetic Resonance Imaging Sedation: Retrospective Cohort Study. Ann Afr Med 2024; 23:669-673. [PMID: 39279171 DOI: 10.4103/aam.aam_109_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 07/04/2024] [Indexed: 09/18/2024] Open
Abstract
THE AIM OF THE PRESENT STUDY The aim of the present study was to do a comparison of the recovery profiles and airway-related adverse events of pediatric magnetic resonance imaging (MRI) sedation patients who received propofol alone to those who received midazolam alone. METHODS This retrospective cohort study was approved by the Mutah University Ethical Approval Committee (No. 2378). A search of the patients' medical records was performed between September 2021 and April 2022 to identify children aged 4 months-11 years who received propofol or midazolam for MRI sedation. The patients were subdivided into two groups: Those who had propofol alone (propofol group) and those who received midazolam (midazolam group) for pediatric MRI sedation. In propofol group, a 1-2 mg/kg of propofol bolus was given to have a deep sedation (Ramsay Sedation Scale score of 5). Patients in midazolam group received 0.05 mg/kg of midazolam. During the maintenance state of sedation, the patient received 150 µg/kg/min of propofol, and the infusion rate was adjusted in 25 μg/kg/min increments up or down at the discretion of the anesthesiologists to maintain a state of deep sedation. The major targets of this study were recovery profiles (time to awake and time to discharge) and airway-related intervention ratios in pediatric MRI sedation patients. Patient demographics, MRI sedation, and recovery data, including propofol induction dose, airway intervention, and sedation-related adverse events from the pediatric sedation recovery unit were also collected. RESULTS The mean (standard deviation [SD]) propofol induction dose was higher compared to midazolam group (2.4 [0.7] mg vs. 1.3 [0.5] mg; mean difference, 1.1 mg; P < 0.001). The mean (SD) infusion rate was higher in propofol group compared to midazolam group (161.3 [37.6] μg/min/kg vs. 116.2 [25.6] μg/min/kg; mean difference 45.1 μg/min/kg; P < 0.001). The mean (SD) propofol total dose was higher in propofol group compared to midazolam group (236.3 [102.4] mg vs. 180.7 [80.9] mg; mean difference, 155.4 mg; P < 0.001). The mean (SD) time to awake was longer in midazolam group compared to propofol group (21.2 [5.6] min vs. 23.0 [7.1] min; mean difference, 1.8 min; P < 0.001). The mean (SD) time to discharge was longer in midazolam group compared to propofol group (34.5 [6.9] min vs. 38.6 [9.4] min; mean difference, 4.1 min; 95% confidence interval, 3.0-5.1; P < 0.001). CONCLUSION The administration of midazolam during pediatric MRI sedation can decrease the frequency of airway complications without prolonging the clinically significant recovery profile.
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Affiliation(s)
| | - Ashraf Aldmour
- Department of Anesthesiology, Mut'ah School of Medicine, Al-Karak, Jordan
| | - Lou'i Al-Husinat
- Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Gehane A El-Gendy
- Department of Pharmacology, Mut'ah School of Medicine, Al-Karak, Jordan
| | - Sherif W Mansour
- Department of Biochemistry, Mut'ah School of Medicine, Al-Karak, Jordan
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Puijk RS, Ziedses des Plantes V, Nieuwenhuizen S, Ruarus AH, Vroomen LGPH, de Jong MC, Geboers B, Hoedemaker-Boon CJ, Thöne-Passchier DH, Gerçek CC, de Vries JJJ, van den Tol PMP, Scheffer HJ, Meijerink MR. Propofol Compared to Midazolam Sedation and to General Anesthesia for Percutaneous Microwave Ablation in Patients with Hepatic Malignancies: A Single-Center Comparative Analysis of Three Historical Cohorts. Cardiovasc Intervent Radiol 2019; 42:1597-1608. [PMID: 31243542 PMCID: PMC6775535 DOI: 10.1007/s00270-019-02273-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/31/2019] [Accepted: 06/13/2019] [Indexed: 02/07/2023]
Abstract
Purpose In percutaneous ablation procedures, periprocedural pain, unrest and respiratory concerns can be detrimental to achieve a safe and efficacious ablation and impair treatment outcome. This study aimed to compare the association between anesthetic technique and local disease control in patients undergoing percutaneous microwave ablation (MWA) of colorectal liver metastases (CRLM) and hepatocellular carcinoma (HCC). Materials and Methods This IRB-exempted single-center comparative, retrospective analysis of three cohorts analyzed 90 patients treated for hepatic malignancies from January 2013 until September 2018. The local tumor progression-free survival (LTPFS), safety and periprocedural pain perception were assessed using univariate and multivariate Cox proportional hazard regression analyses to correct for potential confounders. Results In 114 procedures (22 general anesthesia; 32 midazolam; 60 propofol), 171 liver tumors (136 CRLM; 35 HCC) were treated with percutaneous MWA. Propofol and general anesthesia were superior to midazolam/fentanyl sedation regarding LTPFS (4/94 [4.3%] vs. 19/42 [45.2%] vs. 2/35 [5.7%]; P < 0.001, respectively). Local tumor progression rate was 14.6% (25/171). Eighteen tumors (72.0%) were retreated by ablation. Of them, 14 (78%) were previously treated with midazolam. Propofol versus midazolam (P < 0.001), general anesthesia versus midazolam (P = 0.016), direct postprocedural visual analog pain score above 5 (P = 0.050) and more than one tumor per procedure (P = 0.045) were predictors for LTPFS. Multivariate analysis revealed that propofol versus midazolam (HR 7.94 [95% CI 0.04–0.39; P < 0.001]) and general anesthesia versus midazolam (HR 6.33 [95% CI 0.04–0.69; P = 0.014]) were associated with LTPFS. Pain during and directly after treatment was significantly worse in patients who received midazolam sedation (P < 0.001). Conclusions Compared to propofol and general anesthesia, midazolam/fentanyl sedation was associated with an increased periprocedural perception of pain and lower local tumor progression-free survival. To reduce the number of repeat procedures required to eradicate hepatic malignancies, general anesthesia and propofol sedation should be favored over midazolam.
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Affiliation(s)
- Robbert S Puijk
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - Valentijn Ziedses des Plantes
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Sanne Nieuwenhuizen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Alette H Ruarus
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Laurien G P H Vroomen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Marcus C de Jong
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Bart Geboers
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Caroline J Hoedemaker-Boon
- Department of Anesthesiology, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Deirdre H Thöne-Passchier
- Department of Anesthesiology, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Ceylan C Gerçek
- Department of Anesthesiology, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Jan J J de Vries
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Petrousjka M P van den Tol
- Department of Surgical Oncology, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Hester J Scheffer
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Martijn R Meijerink
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers - location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
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Mondal P, Dalal P, Sathiyadevan N, Snyder DM, Hegde S. Flexible Bronchoscopy Under Bronchoscopist-Administered Moderate Sedation Versus General Anesthesia: A Comparative Study in Children. PEDIATRIC ALLERGY, IMMUNOLOGY, AND PULMONOLOGY 2018; 31:166-173. [PMID: 30279995 PMCID: PMC6167615 DOI: 10.1089/ped.2018.0887] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 05/31/2018] [Indexed: 11/12/2022]
Abstract
Background: Flexible bronchoscopy (FB) can be performed under bronchoscopist administered moderate sedation (BAMS) with a midazolam/fentanyl combination or general anesthesia (GA). However, the outcome of BAMS has not been well established in children. Currently, most of the centers prefer FB under GA. Both techniques have their advantages and disadvantages with implications for safety, complications, and diagnostic yield. The primary objective of our study was to evaluate the safety, time efficiency, and cost-effectiveness of FB under BAMS as compared with FB under GA in a similar setting. Methods: We performed a retrospective chart review to compare BAMS versus GA for FB in children. We recruited BAMS children (n = 295) from University of Florida (UF) Health Shands Children's Hospital, and GA children (n = 100) from Penn State Children's Hospital (PSHCH). Both the groups had similar indications, complexities, and procedural environments. Comparisons of various time-intervals including preprocedure time, sedation-induction time, scope time, and post-procedure time among different BAMS versus GA age-groups were the primary outcomes. The secondary outcomes were the determination of the rates of complications, the dosages of sedative/anesthetic, cost-effectiveness, and sedation patterns under BAMS. Results: FB under BAMS required significantly higher preprocedure times and sedation-induction times (P < 0.001** and P < 0.001** respectively) but shorter scope and post-procedure times compared with the GA group times (P < 0.001** and P < 0.001** respectively). Younger children had a deeper level of sedation for an extended period under BAMS. The costs for the sedation services and the complication rates were lower in the BAMS group compared with the GA group. Conclusion: Our study demonstrated the feasibility of BAMS in children. FB under BAMS had an advantage of lower cost and fewer procedural complications compared with FB under GA. Despite that, the safety of BAMS could not be conclusively established from this retrospective study. Moreover, BAMS can potentially compromise the diagnostic yield because the bronchoscopist is also responsible for monitoring sedation and managing the airway.
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Affiliation(s)
- Pritish Mondal
- Division of Pediatric Pulmonology, Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania
| | - Priti Dalal
- Division of Pediatric Anesthesia, Department of Anesthesia, Penn State College of Medicine, Hershey, Pennsylvania
| | - Niruja Sathiyadevan
- Department of Anesthesia, Penn State College of Medicine, Hershey, Pennsylvania
| | | | - Satyanarayan Hegde
- Division of Pediatric Pulmonology, Department of Pediatrics, University of Chicago, Chicago, Illinois
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Schmitz A, Weiss M, Kellenberger C, O'Gorman Tuura R, Klaghofer R, Scheer I, Makki M, Sabandal C, Buehler PK. Sedation for magnetic resonance imaging using propofol with or without ketamine at induction in pediatrics-A prospective randomized double-blinded study. Paediatr Anaesth 2018; 28:264-274. [PMID: 29377404 DOI: 10.1111/pan.13315] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2017] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Deep sedation using propofol has become a standard technique in children. This double-blinded randomized clinical trial aims to compare the clinical effects of propofol-mono-sedation vs a combination of propofol and ketamine at induction and a reduced propofol infusion rate for maintenance in children undergoing diagnostic magnetic resonance imaging. METHODS Children aged from 3 months to 10 years scheduled as outpatients for elective magnetic resonance imaging with deep sedation were included. They were randomized into 2 groups, receiving either 1 mg/kg ketamine at induction, then a propofol infusion rate of 5 mg/kg/h or a propofol infusion rate of 10 mg/kg/h without prior ketamine. Time to full recovery (modified Aldrete score = 10) was the primary outcome. Further outcomes were quality of induction, immobilization during image acquisition, recovery, postoperative nausea and vomiting, emergence delirium using the Pediatric Anesthesia Emergence Delirium scale, vital signs and adverse cardiorespiratory events. All patients and parents as well as anesthetists, imaging technicians, and postsedation personnel were blinded. Data are given as median (range). RESULTS In total, 347 children aged 4.0 (0.25-10.9) years, weighing 15.6 (5.3-54) kg, ASA classification I, II, or III (141/188/18) were included. The ketamine-propofol group showed significantly shorter recovery times (38 (22-65) vs 54 (37-77) minutes; median difference 14 (95% CI: 8, 20) minutes; P < .001), better quality of induction, and higher blood pressure, but higher incidence of movement requiring additional sedative drugs. There were no significant differences in respiratory side effects, cardiovascular compromise, emergence delirium, or postoperative nausea and vomiting. CONCLUSION Both sedation concepts proved to be reliable with a low incidence of side effects. Ketamine at induction with a reduced propofol infusion rate leads to faster postanesthetic recovery.
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Affiliation(s)
- Achim Schmitz
- Department of Anesthesiology, University Children's Hospital, Zurich, Switzerland.,Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Markus Weiss
- Department of Anesthesiology, University Children's Hospital, Zurich, Switzerland.,Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Christian Kellenberger
- Children's Research Center, University Children's Hospital, Zurich, Switzerland.,Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland
| | - Ruth O'Gorman Tuura
- Children's Research Center, University Children's Hospital, Zurich, Switzerland.,MRI Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Richard Klaghofer
- Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland
| | - Ianina Scheer
- Children's Research Center, University Children's Hospital, Zurich, Switzerland.,Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland
| | - Malek Makki
- Children's Research Center, University Children's Hospital, Zurich, Switzerland.,MRI Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,BioFlow Image, Université de Picardie Jules Verne, Amiens, France
| | - Carola Sabandal
- Department of Anesthesiology, University Children's Hospital, Zurich, Switzerland.,Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Philipp Karl Buehler
- Department of Anesthesiology, University Children's Hospital, Zurich, Switzerland.,Children's Research Center, University Children's Hospital, Zurich, Switzerland.,Department of Intensive Care Medicine, University Hospital, Zurich, Switzerland
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Sedation and analgesia for procedures in the pediatric emergency room. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2017.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Ramalho CE, Bretas PMC, Schvartsman C, Reis AG. Sedation and analgesia for procedures in the pediatric emergency room. J Pediatr (Rio J) 2017; 93 Suppl 1:2-18. [PMID: 28945987 DOI: 10.1016/j.jped.2017.07.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 05/26/2017] [Accepted: 05/26/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Children and adolescents often require sedation and analgesia in emergency situations. With the emergence of new therapeutic options, the obsolescence of others, and recent discoveries regarding already known drugs, it became necessary to review the literature in this area. DATA SOURCES Non-systematic review in the PubMed database of studies published up to December 2016, including original articles, review articles, systematic reviews, and meta-analyses. References from textbooks, publications from regulatory agencies, and articles cited in reviews and meta-analyses through active search were also included. DATA SYNTHESIS Based on current literature, the concepts of sedation and analgesia, the necessary care with the patient before, during, and after sedoanalgesia, and indications related to the appropriate choice of drugs according to the procedure to be performed and their safety profiles are presented. CONCLUSIONS The use of sedoanalgesia protocols in procedures in the pediatric emergency room should guide the professional in the choice of medication, the appropriate material, and in the evaluation of discharge criteria, thus assuring quality in care.
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Affiliation(s)
- Carlos Eduardo Ramalho
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança, São Paulo, SP, Brazil; Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Pediatria, São Paulo, SP, Brazil
| | - Pedro Messeder Caldeira Bretas
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança, São Paulo, SP, Brazil; Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Pediatria, São Paulo, SP, Brazil
| | - Claudio Schvartsman
- Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Pediatria, São Paulo, SP, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, SP, Brazil
| | - Amélia Gorete Reis
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança, São Paulo, SP, Brazil; Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Pediatria, São Paulo, SP, Brazil.
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Kang R, Shin YH, Gil NS, Kim KY, Yeo H, Jeong JS. A comparison of the use of propofol alone and propofol with midazolam for pediatric magnetic resonance imaging sedation - a retrospective cohort study. BMC Anesthesiol 2017; 17:138. [PMID: 29020926 PMCID: PMC5637077 DOI: 10.1186/s12871-017-0431-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/02/2017] [Indexed: 01/29/2023] Open
Abstract
Background Pediatric MRI sedation performed by a variety of specialists such as sedationists and anesthesiologists commonly uses propofol, which has similar effects to an ideal sedative agent for maintaining deep sedation. However, when propofol is used, adverse airway events are relatively more common than when using other sedative agents. The concomitant administration of midazolam and propofol can reduce the dose of propofol needed for adequate sedation and might also reduce the frequency of airway obstruction without affecting the patient’s recovery profile. Methods We reviewed the our hospital records of all pediatric MRI sedation patients aged 3 to 16 years who were sedated with either propofol alone or propofol with midazolam between December 2013 and June 2016. Results Eight hundred ninety-seven pediatric MRI sedation patients were included (n = 897). The frequency of airway intervention was 25/356 (7.0%) in Group P and 15/541 (2.8%) in Group PM (difference in proportions: 4.2%; 95% CI: 1.4–7.6%; p = 0.002). The mean (SD) time to awake was longer in Group PM compared to Group P [21.2 (5.6) minutes vs. 23.0 (7.1) minutes; mean difference, 1.8 min; 95% CI, 0.9–2.9; p < 0.001]. The mean (SD) time to discharge was longer in Group PM compared to Group P [34.5 (6.9) minutes vs. 38.6 (9.4) minutes; mean difference, 4.0 min; 95% CI, 3.0–5.1; p < 0.001]. Conclusions The administration of a small dose of midazolam during pediatric MRI sedation using propofol can reduce the frequency of airway complications without prolonging the clinically significant recovery profile.
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Affiliation(s)
- RyungA Kang
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University school of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 06351, Korea.,Department of Anesthesiology and Pain Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Young Hee Shin
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University school of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 06351, Korea
| | - Nam-Su Gil
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University school of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 06351, Korea
| | - Ki Yoon Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University school of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 06351, Korea
| | - Hyean Yeo
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University school of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 06351, Korea
| | - Ji Seon Jeong
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University school of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 06351, Korea.
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Vagyannavar R, Bhattacharyya A, Misra G, Hashim M, Asmita. Craniopagus twins for magnetic resonance imaging. Saudi J Anaesth 2017; 11:509-510. [PMID: 29033747 PMCID: PMC5637443 DOI: 10.4103/sja.sja_89_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Raghavendra Vagyannavar
- Department of Anaesthesiology and Critical Care, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India
| | - Amrita Bhattacharyya
- Department of Anaesthesiology and Critical Care, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India
| | - Gaurav Misra
- Department of Anaesthesiology and Critical Care, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India
| | - Mohammad Hashim
- Department of Radiology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India
| | - Asmita
- Department of Senior Resident, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India
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Sorensen C, Gach P, Pico H, Hugues N, Dabadie A, Desvignes C, Bourlière B, Aschero A, Colavolpe N, Petit P, Gorincour G. Cardiac CT or MRI in pediatric practice: Which one to choose? Diagn Interv Imaging 2016; 97:513-7. [DOI: 10.1016/j.diii.2016.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 01/30/2016] [Accepted: 02/02/2016] [Indexed: 11/24/2022]
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