The use of melatonin as an alternative to sedation in uncooperative children undergoing an MRI examination.
OBJECTIVE
Children who are uncooperative, due either to their age or medical condition, usually require sedation or a general anaesthetic (GA) to ensure immobility during magnetic resonance imaging (MRI) examination. These procedures have a risk of respiratory compromise and loss of vital reflexes. Melatonin induces a natural sleep with no known complication or risk of respiratory compromise. We aimed to evaluate the use of melatonin in these uncooperative children.


METHODS
An unselected group of 40 children, who had been referred for an MRI examination of the brain under sedation or GA, were chosen to receive melatonin instead. They all received 10 mg of melatonin and 17 children additionally underwent some form of sleep deprivation. The number of children who went to sleep and had a successful MRI examination was recorded.


RESULTS
Twenty-six children (65%) went to sleep and of these 22 (55%) had a successful MRI examination. In the 17 children who underwent sleep deprivation, 13 (76%) went to sleep and had a successful MRI examination. There was no complication.


CONCLUSIONS
Melatonin may provide an alternative to conventional sedation regimes and GA for uncooperative children undergoing an MRI examination. The use of sleep deprivation improves the success rate and there is no risk of respiratory compromise.
Johnson
K
K
Department of Paediatric Radiology, Birmingham Children's Hospital, Birmingham, U.K. karl.johnson@bhamchildrens.wmids.nhs.uk
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Williams
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Wassemer
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Whitehouse
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D000293:Adolescent; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D016292:Procedural Sedation; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008550:Melatonin / Q000494:pharmacology*; D012890:Sleep / Q000187:drug effects*; D012892:Sleep Deprivation
D008550:Melatonin