Trained nurses can provide safe and effective sedation for MRI in pediatric patients

Purpose: To determine the success rate, safety and complications using a st andard protocol and trained nurses to provide sedation for MRI under the su pervision of a radiologist. Materials and Methods: Nurses were trained to provide sedation via a standa rd protocol for pediatric patients undergoing diagnostic MRI. Oral chloral hydrate (80-100 mg.kg(-1))was used for children less than 18 mo of age. Old er children received either 1-6 mg.kg(-1) pentobarbital iv, with or without 1-2 mu g.kg.hr(-1) fentanyl, or 25 mg.kg(-1) thiopental pr. Sedation was d efined as successful if it allowed completion of the MRI without image dist orting patient movement. The records of 572 MRIs performed on 488 pediatric patients (mean age 5 +/- 4 yr; age 2 mo- 14 yr) from 1991 to July 1995 wer e reviewed to determine the success rate and complications using the sedati on program. Results: Most, 91.8% (525/572), of the MRIs were successfully completed in 445 patients. The reasons for failure were inadequate sedation (45, 95.7%) and coughing (2, 4.2%). The failure rate was much higher before 1994 (38/27 2, 14%) than after (9/300, 3%; P < 0.0001). Failure was more common if rect al thiopental was used (23/172, 14%) than intravenous pentobarbital (19/256 , 7.4%; P < 0.05). The failure rate was also high in patients with a histor y of a behavioural disorder (10/59, 17%). There were no deaths or unexpecte d admissions as a result of the sedation program. Conclusion: A high success rate can be achieved as experience is gained usi ng a standard protocol and trained nurses to sedate children for MRI.