{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T02:55:29Z","timestamp":1788576929858,"version":"build-2803163510"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Little is known about the impact of different anesthetic agents used for routine magnetic resonance imaging (MRI) sedation on pulmonary function in children.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare the incidence of pulmonary atelectasis after MRI sedation with propofol vs propofol-ketamine.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This double-masked randomized clinical trial screened 117 consecutive pediatric patients aged 3 to 12 years with American Society of Anesthesiologists physical status I to II undergoing elective MRI under deep sedation from November 2, 2022, to April 28, 2023, at a tertiary referral center. Four patients met the exclusion criteria, and 5 patients refused to participate. The participants and outcome assessors were masked to the group allocation.<\/jats:p><\/jats:sec>Interventions<\/jats:title>During the MRI, the propofol group received 0.2 mL\/kg of 1% propofol and 2 mL of 0.9% saline followed by a continuous infusion of propofol (200 \u03bcg\/kg\/min) and 0.9% saline (0.04 mL\/kg\/min). The propofol-ketamine group received 0.2 mL\/kg of 0.5% propofol and 1 mg\/kg of ketamine followed by a continuous infusion of propofol (100 \u03bcg\/kg\/min) and ketamine (20 \u03bcg\/kg\/min).<\/jats:p><\/jats:sec>Main Outcome and Measure<\/jats:title>The incidence of atelectasis assessed by lung ultrasonography examination.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 107 children (median [IQR] age, 5 [4-6] years; 62 male [57.9%]), with 54 in the propofol group and 53 in the propofol-ketamine group, were analyzed in this study. Notably, 48 (88.9%) and 31 (58.5%) patients had atelectasis in the propofol and propofol-ketamine groups, respectively (relative risk, 0.7; 95% CI, 0.5-0.8; P<\/jats:italic>\u2009&amp;lt;\u2009.001). The incidence of desaturation and interruption of the MRI due to airway intervention or spontaneous movement did not significantly differ between the groups. The propofol-ketamine group showed a faster emergence time than the propofol group (15 [9-23] vs 25 [22-27] minutes in the propofol-ketamine vs propofol group; median difference in time, 9.0 minutes; 95% CI, 6.0-12.0 minutes; P<\/jats:italic>\u2009&amp;lt;\u2009.001). No patient was withdrawn from the trial due to adverse effects.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this randomized clinical trial, the propofol-ketamine combination reduced sedation-induced atelectasis while allowing for faster emergence compared with propofol alone.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>cris.nih.go.kr<\/jats:ext-link> Identifier: KCT0007699<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.33029","type":"journal-article","created":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T15:31:18Z","timestamp":1730475078000},"page":"e2433029","source":"Crossref","is-referenced-by-count":8,"title":["Pulmonary Atelectasis After Sedation With Propofol vs Propofol-Ketamine for Magnetic Resonance Imaging in Children"],"prefix":"10.1001","volume":"7","author":[{"given":"Yu Jeong","family":"Bang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeayoun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nam-Su","family":"Gil","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woo Seog","family":"Sim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun 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