Nonpharmacological interventions to reduce sedation/general anaesthesia in paediatric patients undergoing magnetic resonance imaging: A systematic review and meta‐analysis protocol

Hybschmann, Jane; Povlsen, Nanna Evald; Sørensen, Jette Led; Afshari, Arash; Borgwardt, Lise; Berntsen, Marianne; Madsen, Thurid Waagstein; Gjærde, Line Klingen

doi:10.1111/aas.13851

Cited by 2 publications

(1 citation statement)

References 21 publications

(29 reference statements)

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“…Moreover, interventions to prepare children, have led to reduced sedation rates in certain patient groups (Harrington et al, 2021; Munn & Jordan, 2013). However, evidence of overall effects of nonpharmacological interventions has not been analysed systematically so far (Hybschmann et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Child‐centredness in paediatric magnetic resonance imaging: Information needs and experiences of children requiring magnetic resonance imaging and their parents

Inhestern

Herrmann

et al. 2023

Child

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BackgroundAssessing patient experiences is essential to provide high quality health‐care. The objectives of this study were to examine (1) child‐ and parent‐reported information status before magnetic resonance imaging (MRI), (2) experiences during an MRI and (3) needs and suggestions for improvement.MethodsChildren (≥8 years) and parents answered questionnaires (before and after planned MRI examination) covering mental condition, information status/needs, preparation for MRI, and potential stressors. Before MRI n = 132 accompanying parents and n = 91 children provided data (after MRI: n = 93 parents; n = 71 children). The mean age of the children undergoing MRI was 10.5 years (SD = 4.9). Children had on average seven previous MRIs before our survey (Range: 1–33). Twenty‐three percent of the children were to be sedated during the examination.ResultsParents and children reported low to medium levels of burden, high knowledge and high information status. For the children, most stressful factors during the MRI were boredom and noise. Main information resources were the radiologists or self‐searches. Parents of children with their first MRI reported higher anxiety levels in their children and stated a worse information status (main information source: self‐searches/internet).Parents reported needs regarding organization of the MRI (e.g., reduction of waiting times), age‐appropriate information and communication during the MRI. Children wished to visit the MRI room prior the examination (44%) and to get more information (44%). Children suggested improvements such as better sound quality of films/music, more transparency about the procedure, being in contact with a parent and shorter examinations.ConclusionResults suggest that preparation, information provision and care is perceived positively by families. Needs and suggestions for improvement were, for example, higher transparency of procedures, better communication and reduction of stress. Findings indicate that preparation in routine‐care should follow an individualized child‐focused approach, should focus on families without previous MRIs and should address children with high anxiety levels.

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Section: Discussionmentioning

confidence: 99%

Child‐centredness in paediatric magnetic resonance imaging: Information needs and experiences of children requiring magnetic resonance imaging and their parents

Inhestern

Herrmann

et al. 2023

Child

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Nonpharmacological Interventions to Reduce Sedation and General Anesthesia in Pediatric MRI: A Meta-analysis

Thestrup,

Hybschmann,

Madsen

et al. 2023

Hospital Pediatrics

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CONTEXT: Nonpharmacological strategies are increasingly used in pediatric procedures, but in pediatric MRI, sedation and general anesthesia are still commonly required. OBJECTIVES: To evaluate the effectiveness of nonpharmacological interventions in reducing use of sedation and general anesthesia in pediatric patients undergoing MRI, and to investigate effects on scan time, image quality, and anxiety. DATA SOURCES: We searched Ovid Medline, CINAHL, Embase, and CENTRAL from inception through October 10, 2022. STUDY SELECTION: We included randomized controlled trials and quasi-experimental designs comparing the effect of a nonpharmacological intervention with standard care on use of sedation or general anesthesia, scan time, image quality, or child and parental anxiety among infants (<2 years), children, and adolescents (2–18 years) undergoing MRI. DATA EXTRACTION: Standardized instruments were used to extract data and assess study quality. RESULTS: Forty-six studies were eligible for the systematic review. Limited to studies on children and adolescents, the meta-analysis included 20 studies with 33 873 patients. Intervention versus comparator analysis showed that nonpharmacological interventions were associated with reduced need for sedation and general anesthesia in the randomized control trials (risk ratio, 0.68; 95% confidence interval, 0.48–0.95; l2 = 35%) and nonrandomized studies (risk ratio, 0.58; 95% confidence interval, 0.51–0.66; l2 = 91%). The effect was largest among children aged 3 to 10 years when compared with older children and adolescents aged 11 to 18 years. LIMITATIONS: There was substantial heterogeneity among nonrandomized studies. CONCLUSIONS: Nonpharmacological interventions must be considered as standard procedure in infants, children, and adolescents undergoing MRI.

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Nonpharmacological interventions to reduce sedation/general anaesthesia in paediatric patients undergoing magnetic resonance imaging: A systematic review and meta‐analysis protocol

Cited by 2 publications

References 21 publications

Child‐centredness in paediatric magnetic resonance imaging: Information needs and experiences of children requiring magnetic resonance imaging and their parents

Child‐centredness in paediatric magnetic resonance imaging: Information needs and experiences of children requiring magnetic resonance imaging and their parents

Nonpharmacological Interventions to Reduce Sedation and General Anesthesia in Pediatric MRI: A Meta-analysis

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