Sedation protocol with fasting and shorter sleep leads to magnetic resonance imaging success

• Published in: Pediatrics international Vol. 59; no. 10; pp. 1087 - 1090
• Main Authors: Kimiya, Takahisa, Sekiguchi, Shinichiro, Yagihashi, Tatsuhiko, Arai, Mie, Takahashi, Hirotaka, Takahashi, Takao
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01-10-2017
• Subjects: Administration, Oral; Anesthesia; Child, Preschool; Children; Clinical Protocols; Conscious Sedation - methods; Fasting; Female; Humans; Hypnotics and Sedatives - administration & dosage; Infant; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; magnetic resonance imaging success rate; Male; NMR; Nuclear magnetic resonance; Organophosphates - administration & dosage; Outcome Assessment (Health Care); Pediatrics; Prospective Studies; Resonance; Retrospective Studies; sedation protocol; shorter sleep; Sleep; Sodium; Success; Time Factors; triclofos sodium; triclofos sodium; magnetic resonance imaging success rate; fasting; sedation protocol; shorter sleep
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/ped.13371

Background
Young children undergoing magnetic resonance imaging (MRI) require sedation. In June 2013, Tokyo Metropolitan Ohtsuka Hospital (TMOH) introduced an oral sedation protocol for young children undergoing MRI; the protocol included instructions on fasting before sedation, and recommended a shorter duration of sleep the night before MRI. We compared the MRI success rate before and after the introduction of this protocol.
Methods
The eligible subjects were children under 3 years old who underwent MRI by appointment at TMOH between October 2012 and March 2014, under sedation with triclofos sodium. All those who underwent MRI in or after June 2013 were enrolled prospectively as a post‐protocol group. All patients who underwent MRI before June 2013 were enrolled retrospectively as a pre‐protocol group, with data collected from chart review.
Results
Seventy‐four patients were enrolled in the post‐protocol group, and 42 in the pre‐protocol group. The MRI success rate was significantly higher in the post‐protocol group than in the pre‐protocol group (98.7% vs 88.1%), as was the rate of on‐time starting of MRI (86.5% vs 71.4%). The post‐protocol group woke up earlier on the day of examination (6:18 a.m. vs 6:43 a.m.), resulting in a significantly longer time between awakening and the beginning of sedation (289.8 min vs 265.9 min), and a significantly shorter average duration of sleep on the previous night (504.8 min vs 532.3 min).
Conclusions
Implementation of a hospital‐wide sedation protocol for young children undergoing MRI significantly improved the MRI success rate.