Sedation and Analgesia in MR Imaging

Berlin, Leonard

doi:10.2214/ajr.177.2.1770293

Cited by 19 publications

(12 citation statements)

References 7 publications

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“…To complete the scan, conscious sedation and additional sequences (after sedation) may be necessary in these patients. This situation involves significant risks of adverse events [7-9] and is associated with additional costs because it reduces workflow, limits patient acceptance, and wastes valuable scanning time and thus induces costs. On the other hand, prematurely terminated scans as well mean an important financial loss for the health care system.…”

Section: Discussionmentioning

confidence: 99%

“…Randomization will be done as the most decisive evidence for judging the efficacy of diagnostic tests comes from randomized comparisons in which the controlled design obviates the biases of observational studies [15,16]. Patients who are assigned to imaging in one MR scanner but cannot bear this procedure due to claustrophobic anxiety will be cross-referred to imaging in the other scanner in order to preclude adverse events associated with sedation [7-9]. This will also allow direct comparison of the two options in those patients as an ancillary study.…”

Section: Discussionmentioning

confidence: 99%

“…In order to improve patient acceptance, patients who are assigned to imaging in one MR scanner but cannot bear this procedure due to claustrophobia will not be sedated (with conscious sedation according to the standards of the American Society of Anesthesiology) [17], but will be cross-referred to imaging in the other scanner in order to preclude adverse events associated with sedation (Figure 3) [7-9]. This will also allow direct comparison of the two options in those patients as an ancillary study, which would otherwise be unethical.…”

Section: Methodsmentioning

confidence: 99%

“…In these patients conscious sedation and additional sequences (after sedation) may be necessary to complete the examinations. This situation involves significant risks of adverse events [7-9] and is associated with extra costs because it reduces workflow, limits patient acceptance, and wastes valuable scanning time. Improving comfort during MR imaging (mainly reduction of noise and sensations of confinement by a fairly panoramic view) appears to be essential to avoid claustrophobic reactions [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Reduction of claustrophobia during magnetic resonance imaging: methods and design of the "CLAUSTRO" randomized controlled trial

et al. 2011

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BackgroundMagnetic resonance (MR) imaging has been described as the most important medical innovation in the last 25 years. Over 80 million MR procedures are now performed each year and on average 2.3% (95% confidence interval: 2.0 to 2.5%) of all patients scheduled for MR imaging suffer from claustrophobia. Thus, prevention of MR imaging by claustrophobia is a common problem and approximately 2,000,000 MR procedures worldwide cannot be completed due to this situation. Patients with claustrophobic anxiety are more likely to be frightened and experience a feeling of confinement or being closed in during MR imaging. In these patients, conscious sedation and additional sequences (after sedation) may be necessary to complete the examinations. Further improvements in MR design appear to be essential to alleviate this situation and broaden the applicability of MR imaging. A more open scanner configuration might help reduce claustrophobic reactions while maintaining image quality and diagnostic accuracy.Methods/DesignWe propose to analyze the rate of claustrophobic reactions, clinical utility, image quality, patient acceptance, and cost-effectiveness of an open MR scanner in a randomized comparison with a recently designed short-bore but closed scanner with 97% noise reduction. The primary aim of this study is thus to determine whether an open MR scanner can reduce claustrophobic reactions, thereby enabling more examinations of claustrophobic patients without incurring the safety issues associated with conscious sedation. In this manuscript we detail the methods and design of the prospective "CLAUSTRO" trial.DiscussionThis randomized controlled trial will be the first direct comparison of open vertical and closed short-bore MR systems in regards to claustrophobia and image quality as well as diagnostic utility.Trial RegistrationClinicalTrials.gov: NCT00715806

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reduction of claustrophobia during magnetic resonance imaging: methods and design of the "CLAUSTRO" randomized controlled trial

et al. 2011

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“…In some cases, sedation is not sufficient, so it is necessary to introduce the patient in a short-term general anesthesia. In addition to the possible side effects of anesthesia [16] [17] there are also additional costs due to a disrupted and reduced working process (workflow), limited ability of the patient to cooperate and the spent time intended for imaging [18].…”

Section: Introductionmentioning

confidence: 99%

Patient’s Comfort and Technical Quality Exams at 1.5 and 3.0 T Magnetic Resonance Imaging

Vujmilović¹,

Vujnović²,

Kovačević-Dragosavljević³

et al. 2016

OJRad

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Increased interest of clinicians for using 3.0 T magnetic resonance imaging (MRI), as imaging modality of choice for their patients, has been evident in the past few years. The aim of this study was to compare the technical quality of the obtained tomography using 3.0 T and 1.5 T MRI, and to compare the subjective feeling of discomfort of patients and subjective acoustic noise experience during imaging using MRI at 3.0 T and 1.5 T. Brain MRI (1.5 and 3.0 T) was performed in 58 patients, according to a standardized protocol. All studies have been randomly described by independent two radiologists. The reference standard for the existence of technical artifact is established on the basis of both radiologists' consensus. We also compared the subjective feelings of the discomfort and acoustic noise during the both MRI (1.5 T and 3.0 T) exams. Artifacts were significantly more common during 3.0 T MRI in comparison with the 1.5 T MRI (χ 2 = 5.286, P < 0.05), as well as in male patients (χ 2 = 8.841, P < 0.05), and subjective assessments of discomfort and acoustic noise were higher in patients who underwent imaging using 3.0 T MRI, (χ 2 = 125.959, df = 1, P < 0.001) and in females (χ 2 = 195.449, df = 1, P < 0.001). Additional research is needed to prove that appropriate information for patients about the discomfort during 3.0 T MRI and their psychological preparation is very important element for optimal use of 3.0 T MRI in daily clinical practice.

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Claustrophobia during magnetic resonance imaging: Cohort study in over 55,000 patients

Dewey

Schink

Dewey³

2007

Magnetic Resonance Imaging

209

181

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Purpose: To evaluate whether MR scanners with acoustic noise reduction and a short magnetic bore reduce the rate of claustrophobic reactions. Materials and Methods:We performed a cohort study in an outpatient setting, enrolling a total of 55,734 consecutive patients referred for MRI of any part of the body based on a clinical indication. Imaging was performed using a conventional MR scanner (42,998 patients) and a recently developed MR scanner (12,736 patients) with 97% acoustic noise reduction and a short bore. Multiple logistic regression analysis was used to adjust for the nonrandomized design.Results: In addition to those undergoing head-first examinations, female and middle-aged patients were significantly more likely to develop claustrophobia in the logistic regression analysis (P Ͻ 0.001). The rate of claustrophobic reactions was significantly lower with the recent MR scanner (0.7%; 95% confidence interval [CI]: 0.6 -0.9%) than with the conventional scanner (2.1%; 95% CI, 2.0 -2.3%; P Ͻ 0.001) with an adjusted odds ratio (OR) of 3.1 (95% CI, 2.5-3.9) and a number needed to treat of 72 (95% CI, 63-85). Conclusion:The incidence of claustrophobia may be reduced by a factor of 3 when recently-developed MR scanners are used.

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Sedation and Analgesia in MR Imaging

Cited by 19 publications

References 7 publications

Reduction of claustrophobia during magnetic resonance imaging: methods and design of the "CLAUSTRO" randomized controlled trial

Reduction of claustrophobia during magnetic resonance imaging: methods and design of the "CLAUSTRO" randomized controlled trial

Patient’s Comfort and Technical Quality Exams at 1.5 and 3.0 T Magnetic Resonance Imaging

Claustrophobia during magnetic resonance imaging: Cohort study in over 55,000 patients

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