Kimiya Takahisa, Sekiguchi Shinichiro, Yagihashi Tatsuhiko, Arai Mie, Takahashi Hirotaka, Takahashi Takao
Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan.
Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
Pediatr Int. 2017 Oct;59(10):1087-1090. doi: 10.1111/ped.13371. Epub 2017 Sep 29.
Young children undergoing magnetic resonance imaging (MRI) require sedation. In June 2013, Tokyo Metropolitan Ohtsuka Hospital (TMOH) introduced an oral sedation protocol for young children undergoing MRI; the protocol included instructions on fasting before sedation, and recommended a shorter duration of sleep the night before MRI. We compared the MRI success rate before and after the introduction of this protocol.
The eligible subjects were children under 3 years old who underwent MRI by appointment at TMOH between October 2012 and March 2014, under sedation with triclofos sodium. All those who underwent MRI in or after June 2013 were enrolled prospectively as a post-protocol group. All patients who underwent MRI before June 2013 were enrolled retrospectively as a pre-protocol group, with data collected from chart review.
Seventy-four patients were enrolled in the post-protocol group, and 42 in the pre-protocol group. The MRI success rate was significantly higher in the post-protocol group than in the pre-protocol group (98.7% vs 88.1%), as was the rate of on-time starting of MRI (86.5% vs 71.4%). The post-protocol group woke up earlier on the day of examination (6:18 a.m. vs 6:43 a.m.), resulting in a significantly longer time between awakening and the beginning of sedation (289.8 min vs 265.9 min), and a significantly shorter average duration of sleep on the previous night (504.8 min vs 532.3 min).
Implementation of a hospital-wide sedation protocol for young children undergoing MRI significantly improved the MRI success rate.
接受磁共振成像(MRI)检查的幼儿需要镇静。2013年6月,东京都大塚医院(TMOH)引入了针对接受MRI检查幼儿的口服镇静方案;该方案包括镇静前禁食的说明,并建议在MRI检查前一晚缩短睡眠时间。我们比较了该方案引入前后MRI检查的成功率。
符合条件的受试者为2012年10月至2014年3月在TMOH预约接受MRI检查、使用三氯福司钠镇静的3岁以下儿童。2013年6月及以后接受MRI检查的所有儿童均前瞻性纳入方案后组。2013年6月之前接受MRI检查的所有患者均回顾性纳入方案前组,数据通过病历审查收集。
方案后组纳入74例患者,方案前组纳入42例患者。方案后组的MRI检查成功率显著高于方案前组(98.7%对88.1%),MRI按时开始率也是如此(86.5%对71.4%)。方案后组在检查当天醒来更早(上午6:18对上午6:43),导致醒来至开始镇静之间的时间显著更长(289.8分钟对265.9分钟),且前一晚的平均睡眠时间显著更短(504.8分钟对532.3分钟)。
对接受MRI检查的幼儿实施全院范围的镇静方案显著提高了MRI检查的成功率。