The Effects of Anesthesia on the Pediatric Developing Brain: Strategies to Reduce Anesthesia Use in Pediatric MRI and Nursing's Role in Driving Patient Safety

Interventions and methods to prepare, educate or familiarise children and young people for radiological procedures: a scoping review

“…Just before the MRI, children were individually trained and practice trials were repeated until the children understood the task Study coordinator Preparation and training were conducted on the day of the scan State anxiety scores Scan success (acceptable amount of head motion) Repetition rates Cancellations due to refusals Expression of distress while in the scanner Compliance was not significantly different between ADHD and control groups based on success, failure, and repetition rates of fMRI. Compliance of ADHD patients with extreme levels of anxiety was also not significantly different Mastro et al (2019) [ 58 ] To evaluate the effectiveness of an anaesthesia-free patient- and family-centred intervention through an analysis of MRI quality, health-care costs, and operational efficiency as compared with other approaches Retrospectivereview of electronic medical records 500 children aged 3–17 years, who underwent outpatient MRI 125 children in each of four different intervention arms Pre MRI preparation session included a preparation book on iPad (with sounds, pictures, and text) covering all stages of the MRI visit. A medical play session led by the child with a mock toy MRI scanner with figures and dolls.…”

“…The majority of the studies focussed exclusively on MRI scans (n = 29) [ 24 , 28 , 29 , 31 , 32 , 34 – 36 , 38 – 42 , 45 , 47 – 56 , 58 , 59 ]. The other studies focussed on interventions linked to children undergoing intravenous pyelograms (n = 2) [ 25 , 26 ] voiding cystourethrograms (VCUG) (n = 2) [ 26 ], dimercaptosuccinic acid (DMSA) scans (n = 1), chest radiography (n = 1) [ 27 ] or interventions linked to multiple radiological procedures, CT, MRI, nuclear medicine and fluoroscopy (n = 3) [ 30 , 44 , 46 ].…”

“…The interventions using technology included smartphone applications (n = 4) [ 30 , 34 , 44 , 49 ], interactive videos (n = 2) [ 31 , 33 ], animations (n = 3) [ 33 , 41 , 50 ] and one study focussed on virtual reality information [ 27 ]. The most frequent non-invasive intervention described was the opportunity to practice undergoing a procedure, to model what would happen and experience the sensory elements involved in undergoing an MRI scan; these included mock scanners (n = 9) (both toy-sized or pretend full-sized scanners) [ 24 , 35 , 37 , 47 , 48 , 51 , 53 , 55 , 57 ], one study using simulated practice [ 32 ] and studies with a focus on play-based learning and preparation (n = 7) [ 38 , 39 , 45 , 54 , 56 , 58 , 59 ].…”

“…During the study period, is the intervention administered (or exposure occurred) as intended? Carter et al (2010) [ 55 ] Yes Yes Yes Yes Yes Cannot tell Yes Cavarocchi et al (2019) [ 38 ] Yes Yes Yes Yes Yes Yes Yes Cedja et al (2012) [ 56 ] Yes Yes Yes Yes No Cannot tell Yes deAmorin e Silva (2006) [ 57 ] Yes Yes Yes Yes Yes Cannot tell Yes Johnson et al (2009) [ 46 ] Yes Yes Yes Yes Yes No Yes Karakas et al (2015) [ 40 ] Yes Yes Cannot tell Yes Yes No Yes Mastro et al (2019) [ 58 ] Yes Yes Yes Yes Yes Cannot tell …”

Children and Neonates Anesthesia in Magnetic Resonance Environment in Italy. An active Call Survey

“…The therapeutic window between sedation and anaesthesia is very narrow for paediatric patients, and the burden of adverse events not trivial [6]. Moreover, the recent debate about neurotoxicity of anaesthetics in developing age [7][8], prompted the anaesthesiological community to produce many papers and reviews about the role of the anaesthetists during MRI for children and neonates [9][10].…”