Most Children May Not Need Sedation for MRI

A quick screening tool may identify pediatric patients who could benefit from simulation training in order to complete an MRI examination without anesthesia, according to a study published in the Journal of the American College of Radiology.

Researchers from Nationwide Children’s Hospital in Columbus, Ohio, performed a study to see if simulation training among children could reduce the need for anesthesia for some about to undergo MR imaging. The study evaluated the use of the modified Yale Preoperative Anxiety Scale (mYPAS) for this purpose.

The study included 80 children, aged 5 and older, originally scheduled for MRI with anesthesia. The mYPAS assessment was performed by trained certified child life specialists before and after practice MRI sessions. The primary outcome was whether mYPAS could predict completing an MRI examination without anesthesia.

The results showed that of the 43 boys and 37 girls (mean age 8.5 3.0 years) enrolled in the study, 11 subjects (14 percent) required general anesthesia to complete the MRI examination despite participating in the simulation. In the overall cohort, mYPAS scores improved after simulation from 31 ± 11 to 27 ± 9. Receiver operating characteristic curve analysis found that presimulation mYPAS had good utility for predicting anesthesia requirement for MRI completion (area under the curve = 0.81). A presimulation mYPAS score of more than 33 predicted need for anesthesia with 82 percent sensitivity and 78 percent specificity.

The researchers concluded that the mYPAS is a quick screening tool to identify pediatric patients who could benefit from simulation training by being able to complete an MRI examination without anesthesia.