Sedation/general anesthesia for magnetic resonance imaging in paediatric patients – special considerations and safety
D. Tzoneva, V. Guergueltcheva, T. Chamova, St. Hinev
|Magnetic resonance imaging (MRI) study requires the patient to remain motionless for extended periods of time, which can not be achieved in children without special care or drug-induced sleep. There are various methods for sedation / general anaesthesia (GA) in children with their different advantages and disadvantages. The aim of this study was to report our experience with sedation/GA in children who require MRI/computed-tomography (CT) studies.We performed a retrospective review of the sedation/GArecords in 34 children aged from 6 months to 12 years; classASA I-III, undergoing diagnostic MR/CT study. Demographic data, information regarding diagnosis, type of sedation/GA, use of premedication, time to readiness for the procedure afterpremedication administration, duration of procedure, and the
recovery time were obtained. Any adverse events were noted. Imaging study in most of the patients (61.8%) was performed for neurological diseases (delayed neuropsychological development, epilepsy, and cerebral palsy). Sedation/GA with Propofol was administered in 50% (n=17) of patients, in 26.5% (n=9) – Ketamine plus Midazolam; in 20.6% (n=7) – Midazolam alone, and in 9% (n=1) – Thiopental. The time to readiness for the procedure and the recovery time were statistically significantly shorter for patients receiving Propofol, and the observed adverse respiratory events were mild in severity,when compared with patients receiving sedation/GA with another hypnotic agent (p<0.05). The evaluation of the respiratory system before sedation/GA should be carefully performed, as the respiratory diseases could increase the patients’ risk of adverse events occurrence. Sedation/GA with Propofol is a method of choice in children with neurological disorders with seizures, increased intracranial pressure and myopathies, undergoing MR/CT study. Crucial for patients’ safety and good clinical results is the medical professionals, delivering sedation/GA, to have the knowledge and practical experience in paediatric anaesthesia in the specific conditions of the MR environment.
Key words: GENERAL ANAESTHESIA. SEDATION. ANAESTHETIC TECHNIQES. PAEDIATRIC PATIENTS. MAGNETIC RESONANCE IMAGING. SAFETY