Anaesthesia or sedation for paediatric MRI

Abstract

The purpose of the present review is to place the current literature into historical context of what is understood about the conceptual as well as practical differences between sedation and anaesthesia, and what the potential benefits and risks may be, where paediatric imaging is concerned. This review is timely, as there is an increasing demand for the expensive resource of anaesthesia service provision, above and beyond sedation provision. Adequate and appropriate training is the major issue in well tolerated drug administration: the practitioner must have appropriate skills to monitor and rescue the patient from general anaesthesia. There is an increasing understanding on what can be achieved with subanaesthetic doses of traditional anaesthetic drugs, as well as what can be achieved without access to anaesthetic drugs at all. The risk-benefit analysis must ultimately be taken on a patient-by-patient basis, and to this end should determine service provision and training requirements. One single method cannot be applied to all children. Many can be sedated, but others will need anaesthesia with careful airway management, and the accompanying skilled personnel. Service models should be developed and tested to ensure maximum efficiency of service delivery.