Anesthesia and Intensive Care Department, University Hospital of Tours, 2 Boulevard Tonnelé, 37044, Tours, France.
UMR 1253, iBrain, Inserm, University of Tours, 37000, Tours, France.
Pediatr Radiol. 2023 Jul;53(8):1669-1674. doi: 10.1007/s00247-023-05635-4. Epub 2023 Mar 18.
Pediatric magnetic resonance imaging (MRI) and computed tompgraphy (CT) require patient immobility and therefore often require sedation or general anesthesia of patients. Consensus on these procedures is lacking in France.
Thus, the aim of this study was to describe the current sedation practices for pediatric MRI and CT in France.
From January 2019 to December 2019, an online questionnaire was delivered by electronic mail to a representative radiologist in 60 pediatric radiology centers registered by the French-speaking pediatric and prenatal imaging society. Questions included protocols, drugs used, monitoring and side effects.
Representatives of 40 of the 60 (67%) radiology centers responded to the survey. Among them, 31 performed sedation including 17 (55%) centers where radiologists performed sedation without anesthesiologists present during the procedure. The premedication drugs were hydroxyzine (n = 8, 80%) and melatonin (n = 2, 20%), Sedation drugs used for children ages 0 to 6 years old were pentobarbital (n = 9, 60%), midazolam (n = 2, 13%), chloral hydrate (n = 2, 13%), diazepam (n = 1, 6.5%) and chlorpromazine (n = 1, 6.5%). A written sedation protocol was available in 10/17 (59%) centers. In 6/17 (35%) centers, no monitoring was used during the procedures. Blood pressure monitoring and capnography were rarely used (< 10%) and post-sedation monitoring was heterogeneous. No life-threatening adverse effect was reported, but 6 centers reported at least one incident per year.
For half of the responding radiology centers, radiologists performed sedation alone in agreement with the local anesthesiology team. Sedation procedures and monitoring were heterogenous among centers. Adjustment and harmonization of the practices according to the capacity of each center may be useful.
儿科磁共振成像（MRI）和计算机断层扫描（CT）需要患者保持不动，因此通常需要对患者进行镇静或全身麻醉。法国缺乏对此类程序的共识。
因此，本研究旨在描述法国目前儿科 MRI 和 CT 的镇静实践。
从 2019 年 1 月至 2019 年 12 月，通过电子邮件向法语儿科和产前影像学协会注册的 60 个儿科放射科中心中的一名代表放射科医生发送了在线问卷。问题包括方案、使用的药物、监测和副作用。
在 60 个放射科中心中有 40 个（67%）的代表对调查做出了回应。其中，31 个中心进行了镇静，其中 17 个（55%）中心在没有麻醉师在场的情况下由放射科医生进行镇静。预给药药物为羟嗪（n=8，80%）和褪黑素（n=2，20%）。用于 0 至 6 岁儿童的镇静药物为戊巴比妥（n=9，60%）、咪达唑仑（n=2，13%）、水合氯醛（n=2，13%）、地西泮（n=1，6.5%）和氯丙嗪（n=1，6.5%）。17 个中心中的 10 个（59%）有书面镇静方案。在 17 个中心中的 6 个（35%）中心，在程序中未使用任何监测。血压监测和呼气末二氧化碳监测很少使用（<10%），镇静后监测方法各不相同。没有报告危及生命的不良事件，但 6 个中心每年至少报告 1 起事件。
对于一半的回应放射科中心，放射科医生在与当地麻醉团队协商一致的情况下单独进行镇静。中心之间的镇静程序和监测方法存在差异。根据每个中心的能力调整和协调实践可能是有用的。
