Magnetic Resonance Imaging under Sedation in Pediatric Patients: A Single-Institution Experience

IF 0.3 Q4 PEDIATRICS Journal of Child Science Pub Date : 2021-01-01 DOI:10.1055/s-0041-1731335
Ilker Onguc Aycan, Y. Taseli, H. Temel, B. Dinç, N. Coskunfirat, S. Sanli
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Abstract

Abstract Magnetic resonance imaging (MRI) scans for children are a challenge for anesthesiologists since the child must be sedated enough to stand still. But anesthetic drugs used for sedation might have serious side effects and monitorization resources and accessibility to the patient during MRI scan is limited. We retrospectively examined 977 pediatric patients' files who had MRI scans in our hospital. We observed that children received one of the four combinations of anesthetic drugs: group 1 received midazolam, propofol, and ketamine; group 2 received midazolam and ketamine; group 3 received midazolam and thiopental; and group 4 received midazolam and propofol combination for sedation. The patients in group 1 had significantly higher vomiting rates than the patients in group 4 (p = 0.005). We observed bronchospasm in patients in group 1 (p = 0.006) and group 3 (p = 0.001), more than in patients in group 4. Nausea and vomiting ratios were lower in group 4. In patients with nausea and vomiting within a week after the procedure, statistically significant lower neutrophil–lymphocyte ratio values (p = 0.012) were observed. All four anesthetic combinations used in the trial provided safe anesthesia for the children, during the MRI scan. The anesthetic choice must be made according to the procedure time and patient's comorbidities. In this trial, we observed minimum side effects with midazolam and propofol combination.
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儿童患者镇静下的磁共振成像:单一机构的经验
摘要儿童核磁共振成像(MRI)扫描对麻醉师来说是一个挑战,因为儿童必须服用足够的镇静剂才能站立不动。但用于镇静的麻醉药物可能会有严重的副作用,MRI扫描期间患者的监测资源和可及性有限。我们回顾性地检查了977名在我们医院进行MRI扫描的儿科患者的档案。我们观察到,儿童接受了四种麻醉药物组合中的一种:第一组接受咪唑安定、丙泊酚和氯胺酮;第2组给予咪唑安定和氯胺酮;第3组给予咪唑安定和硫喷妥钠;第4组给予咪唑安定和丙泊酚联合镇静。第1组患者的呕吐率明显高于第4组患者(p = 0.005)。我们观察到第1组患者的支气管痉挛(p = 0.006)和第3组(p = 0.001),高于第4组患者。第4组恶心呕吐率较低。在术后一周内出现恶心和呕吐的患者中,中性粒细胞-淋巴细胞比值降低具有统计学意义(p = 0.012)。试验中使用的所有四种麻醉剂组合在MRI扫描期间为儿童提供了安全的麻醉。必须根据手术时间和患者的合并症来选择麻醉剂。在本试验中,我们观察到咪唑安定和丙泊酚联合用药的副作用最小。
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