What happens when young patients undergo MRI scans without anesthesia?

Providing pediatric patients with MRI scans without anesthesia is an example of patient- and family-centered care (PFCC) in action, according to new research published in the Journal of Radiology Nursing. The authors found that this practice can lead to lower healthcare costs and shorter procedure times.

“MRI has emerged as the standard of care for diagnosis and follow-up of many conditions, and more children are being subjected to anesthesia to ensure acceptable motion-free image quality of the MRI scans,” wrote author Kari A. Mastro, PhD, RN, NEA-BC, of the St. Mary Medical Center in Langhorne, Pennsylvania, and colleagues. 

The researchers noted that children who are less than three years of age and have complex and/or chronic conditions do require anesthesia. However, they may be at risk for acute adverse physiologic events that are related to anesthesia—including short- and long-term psychological and neurobehavioral issues.

Mastro and colleagues sought to determine the impact of an anesthesia-free patient- and family-centered intervention on MRI quality, healthcare costs and operational efficiency.

The intervention group, with patient- and family-center preparation of the child and no anesthesia given (PFC/NA), was compared to the following three groups.

  • No structured preparation, and no anesthesia given (SC/NA)
  • Certified child life specialist preparation, and anesthesia given (CCLS/A)
  • No structured preparation, anesthesia given (SC/A)

The study retrospectively reviewed the patient data of 500 patients aged 3-17 years who underwent outpatient MRI at a medical center in New York City from 2015 to 2016. Each group had 125 individuals who were used to determine the outcome variables.

The researchers found the quality of the MRI scans in both the CCLS/A group and SC/A group were better than the quality provided in the intervention group. Approximately 97 percent of the MRI images studied were “acceptable” or “better quality” than the SC/A and the CCLS/A groups.

The researchers also determined that the PFC/NA group had significantly lower costs and shorter procedure times. 

“The findings from this study have provided the first evidence that supports a safer, more cost-effective, and more efficient alternative to anesthesia use in children needing a diagnostic MRI," the researchers concluded. “The results of this research reveal that taking a patient- and family-centered approach to care reduces the need for anesthesia in children needing outpatient MRI, thus improving the safety of care for this population.”