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

Citation
Ds. Beebe et al., Trained nurses can provide safe and effective sedation for MRI in pediatric patients, CAN J ANAES, 47(3), 2000, pp. 205-210
Citations number
15
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Journal title
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE
ISSN journal
0832610X → ACNP
Volume
47
Issue
3
Year of publication
2000
Pages
205 - 210
Database
ISI
SICI code
0832-610X(200003)47:3<205:TNCPSA>2.0.ZU;2-U
Abstract
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.