Alternatives to Sedation and General Anesthesia in Pediatric Magnetic Resonance Imaging: A Literature Review.
OBJECTIVE
To assess alternatives to sedation and general anesthesia to prepare children for magnetic resonance (MR) imaging examinations.


METHODS
Online databases were searched for articles discussing methods of preparing children for MR imaging procedures. Because of the large number of articles returned, criteria were limited to only studies that prepared patients without the use of sedation or general anesthesia.


RESULTS
Twenty-four studies were deemed appropriate for inclusion in the review. The following methods emerged as alternatives to pediatric sedation: mock scanners, MR-compatible audiovisual systems, feed-sleep manipulation, play therapy, infant incubators/immobilizers, photo diaries, sucrose solutions, and guided imagery. The approaches with the most extensive research were mock MR scanners and feed-sleep manipulation.


CONCLUSIONS
Evidence supports the use of these alternative techniques as valid substitutes for pediatric sedation and general anesthesia.


CONCLUSIONS
To reduce the risks associated with sedation of pediatric patients, institutions could implement the alternatives discussed in this review. Cost analyses should be conducted first because some methods are more expensive than others. Finally, further research is needed to better assess the effectiveness of lesser-practiced methods, including photo diaries, sucrose solutions, and guided imagery.
Delaney
D
McGuirt
D000768:Anesthesia, General / Q000379:methods; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods; D005260:Female; D006801:Humans; D007103:Immobilization / Q000379:methods* / Q000523:psychology; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000009:adverse effects / Q000523:psychology*; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D010372:Pediatrics; D010989:Play Therapy / Q000379:methods*; D016896:Treatment Outcome
MRI procedures; alternatives to sedation; avoiding sedation in pediatric MRI; pediatric sedation; preparing children for MRI