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Sedation of Pediatric Patients in Magnetic Resonance Imaging

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Technical Report

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Uniformed Services University Of The Health Sciences Bethesda United States

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Magnetic resonance imaging MRI, a non-invasive radiographic test, is used toaid the diagnosis of diseases and abnormalities. It requires a cooperative and immobilepatient for approximately 30-90 minutes Tobin, Spurrier, and Wetzel, 1992.Immobilizing a child for this length of time is a challenge. History has shown that mostyoung children are unable to remain motionless for the extended length of time necessaryto perform a MRI examination without sedation Bisset and Ball, 1991. Providing thesedation is the responsibility of the anesthesia provider. Sedation of the pediatric patient is a process carefully planned by the anesthesiaprovider. Achieving cooperation and immobility of the patient are the main concerns forthe radiologist while performing the MRI scan. Any sudden movements by the pediatricpatient can result in an inconclusive scan. Hubbard, Markowitz, Kimmel, Kroger, andBartko 1992 demonstrated that the failure of sedation to enable completion of anexamination is more frequent with MRI scan than with other imaging modalities. Astudy by Slovis and associates 1993 concluded that after repeated failed MRI scans, it is advisable to use the most effective drug regimen with the fewest side effects to providesedation for pediatric patients. The problem for the anesthesia provider is developing asedation regimen that renders immobility of the pediatric patient without compromisingtheir respiratory or hemodynamic status. At a midwest medical facility near Dayton,Ohio, such a regimen has been developed and implemented.

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