Complications of three deep sedation methods for magnetic resonance imaging

Tith, Solina; Lalwani, Kirk; Fu, Rongwei

doi:10.4103/0970-9185.94837

Cited by 14 publications

(7 citation statements)

References 19 publications

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“…Distress during acquisition may lead to premature termination of the scan or reduce image quality due to motion artifacts, impeding proper interpretation of images [6]. Therefore, many patients need conscious sedation to complete the examination [12,13], which requires monitoring of vital functions and exposes patients to the risk of severe complications [14]. Furthermore, medical sedation requires an experienced operator to ensure maximum efficiency, which is not available in all hospitals or outpatient centers [15].…”

Section: Introductionmentioning

confidence: 99%

Audio-guided self-hypnosis for reduction of claustrophobia during MR imaging: results of an observational 2-group study

Napp

Diekhoff

Stoiber³

et al. 2021

Eur Radiol

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Objectives To evaluate the influence of audio-guided self-hypnosis on claustrophobia in a high-risk cohort undergoing magnetic resonance (MR) imaging. Methods In this prospective observational 2-group study, 55 patients (69% female, mean age 53.6 ± 13.9) used self-hypnosis directly before imaging. Claustrophobia included premature termination, sedation, and coping actions. The claustrophobia questionnaire (CLQ) was completed before self-hypnosis and after MR imaging. Results were compared to a control cohort of 89 patients examined on the same open MR scanner using logistic regression for multivariate analysis. Furthermore, patients were asked about their preferences for future imaging. Results There was significantly fewer claustrophobia in the self-hypnosis group (16%; 9/55), compared with the control group (43%; 38/89; odds ratio .14; p = .001). Self-hypnosis patients also needed less sedation (2% vs 16%; 1/55 vs 14/89; odds ratio .1; p = .008) and non-sedation coping actions (13% vs 28%; 7/55 vs 25/89; odds ratio .3; p = .02). Self-hypnosis did not influence the CLQ results measured before and after MR imaging (p = .79). Self-hypnosis reduced the frequency of claustrophobia in the subgroup of patients above an established CLQ cut-off of .33 from 47% (37/78) to 18% (9/49; p = .002). In the subgroup below the CLQ cut-off of 0.33, there were no significant differences (0% vs 9%, 0/6 vs 1/11; p = 1.0). Most patients (67%; 35/52) preferred self-hypnosis for future MR examinations. Conclusions Self-hypnosis reduced claustrophobia in high-risk patients undergoing imaging in an open MR scanner and might reduce the need for sedation and non-sedation coping actions. Key Points • Forty percent of the patients at high risk for claustrophobia may also experience a claustrophobic event in an open MR scanner. • Self-hypnosis while listening to an audio in the waiting room before the examination may reduce claustrophobic events in over 50% of patients with high risk for claustrophobia. • Self-hypnosis may also reduce the need for sedation and other time-consuming non-sedation coping actions and is preferred by high-risk patients for future examinations.

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Section: Introductionmentioning

confidence: 99%

Audio-guided self-hypnosis for reduction of claustrophobia during MR imaging: results of an observational 2-group study

Napp

Diekhoff

Stoiber³

et al. 2021

Eur Radiol

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“…Movement of the patient during the operation may interfere with image interpretation and disrupt the scan, which may necessitate repeating the procedure. Therefore, GA produces better MRI image quality than sedation because of preventing patient movement ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of Laryngeal Mask Airway on Image Quality in Pediatric Patients Undergoing Brain Magnetic Resonance Imaging: A Randomized Controlled Trial

2023

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Background: Magnetic resonance imaging (MRI) is highly sensitive to motion, resulting in artifacts and lowering image quality. Laryngeal mask airway (LMA) provides numerous advantages over endotracheal tubes as it reduces laryngospasm, coughing, and the risk of postoperative desaturation. Objectives: We aimed to compare LMA with oral airway for airway management during brain MRI in terms of reducing motion artifacts, which can improve image quality. Methods: This randomized, controlled, double-blind trial was carried out on 40 pediatrics aged 1 - 18 years, American Society of Anesthesiologists (ASA) physical status І and П undergoing brain MRI. Patients were randomized into two equal groups according to the airway method, the control (Guedel oral airway) group and the LMA group. A compatible anesthesia machine was used to provide O2 and sevoflurane 2% - 4%. Results: The mean MRI image quality score was significantly higher in the LMA group than in the control group (26.10 ± 3.97 versus 18.60 ± 5.30, P < 0.001). Mean arterial blood pressure and heart rate were significantly lower in the LMA group than in the control group at all study times except at baseline and immediate post-extubation (P < 0.05). Cough was significantly lower in LMA than in the control group (15% vs. 50%, P = 0.040). Airway complications (sore throat, laryngeal spasm, and bronchospasm), nausea, and vomiting did not have a significantly different between the two groups. Conclusions: Compared to Guedel oral airway, using LMA for airway management in pediatrics undergoing MRI scans improved the image quality with less cough and better hemodynamics.

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“…Furthermore, preoperative imaging is not without risks, especially in pediatric patients, in whom exposure to multiple CT scans (≥4) may lead to an increased risk of future neoplasms (8,9). Although this is averted with MRI, the longer scan time may require sedation in young children with its own associated risks (10). Despite the high costs and potential risks of preoperative imaging, its utility has not been extensively studied and may depend on the patient's age.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Imaging in Cochlear Implants

Lee,

Saunders

2024

Otol Neurotol

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Objective To determine the utility of computed tomography (CT) and magnetic resonance imaging (MRI) in cochlear implant candidates. Study Design Retrospective case review. Setting Tertiary referral hospital. Patients A total of 207 cochlear implanted patients with CT and/or MRI Intervention(s) N/A. Main Outcome Measure(s) Age versus abnormal radiologic findings, imaging abnormality versus postoperative outcomes, postoperative outcomes versus electrode design, Cambridge Cochlear Implant Protocol (CCIP) status for imaging abnormalities, sensitivity and specificity of CT and MRI for round-window/cochlear occlusion, and MRI for incomplete partitions. Results A total of 207 patients with CT, MRI, or both were reviewed retrospectively. Less than half (15.5%) of CT scans had findings that might affect surgical intervention compared with 5.9% of MRI. No significant difference was found between children and adults for relevant imaging abnormalities (grade 4 or higher) with either CT (p = 0.931) or MRI (p = 0.606). CCIP status correlated with cochlear abnormalities (p = 0.040); however, only 46.2% of radiographic abnormalities on CT would be identified by these criteria. For detecting cochlear occlusion requiring surgical intervention, the sensitivity and specificity for CT were 40% (4 of 10; 95% confidence interval [CI], 12.16–73.76) and 95.73% (95% CI, 91.40–98.27), respectively. For MRI, the sensitivity and specificity were 33.33% (1 of 3; 95% CI, 0.84–90.57) and 96.97% (63 of 65; 95% CI, 89.32–99.63), respectively. There was no difference for postoperative AzBio scores for higher-grade imaging abnormalities (p = 0.6012) or for electrode designs (p = 0.3699). Conclusions Significant radiographic abnormalities were relatively uncommon in cochlear implant patients on either CT or MRI at our single-center institution. If present, abnormal imaging findings rarely translated to management changes. CCIP status does not reliably predict which patients are likely to have abnormalities. Both MRI and CT have low sensitivity for round-window or cochlear occlusion, but detection likely leads to changes in surgical management.

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Complications of three deep sedation methods for magnetic resonance imaging

Cited by 14 publications

References 19 publications

Audio-guided self-hypnosis for reduction of claustrophobia during MR imaging: results of an observational 2-group study

Audio-guided self-hypnosis for reduction of claustrophobia during MR imaging: results of an observational 2-group study

Effect of Laryngeal Mask Airway on Image Quality in Pediatric Patients Undergoing Brain Magnetic Resonance Imaging: A Randomized Controlled Trial

Preoperative Imaging in Cochlear Implants

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