Updated MRI protocol reduces need to sedate pediatric patients

An abbreviated brain MRI protocol can help reduce the need to sedate young children suffering from headaches, according to a new study published by the American Journal of Roentgenology.

“The Choosing Wisely initiative and the American College of Radiology 2018 Appropriateness Criteria indicate that imaging is not usually performed for primary headache, but that MRI is preferred in the workup of secondary headache,” wrote authors Anna Trofimova, MD, and Nadja Kadom, MD, of Emory University School of Medicine in Atlanta, Georgia. “Clinicians, however, may experience a conflict between evidence-based guidelines for resource utilization and addressing the needs of each of their patients.”

Noting that sedation is associated with a variety of adverse effects, the authors turned to a proven abbreviated brain MRI protocol to see if they could treat children experiencing headaches without any sedation. The researchers only proceeded after a survey revealed that radiologists showed confidence in abbreviated brain MRI.

Overall, Trofimova and Kadom found the updated protocol helped 74 percent of patients 8 years old or younger complete MRI scans without being sedated. All children between the ages of 6 and 8 completed the scan without sedation.

“Our initial assessment has shown reductions in sedation use in 74 percent of the target population,” Trofimova and Kadom wrote. “Additional benefits that could not be quantified but were anecdotally reported included high patient satisfaction and ability of MRI staff to accommodate inpatient MRI studies when scheduled full MRI time slots (45 minutes) were not fully used for the abbreviated brain MRI studies.”