MRI Customized Play Therapy in Children Reduces the Need for Sedation--A Randomized Controlled Trial.

Abstract

To evaluate the effectiveness of an MRI-specific play therapy intervention on the need for sedation in young children. All children in the age group of 4-10 y, who were advised an MRI scan over a period of one year were randomized. Exclusion criteria included children with neurodevelopmental disorders impairing cognition and children who had previously undergone diagnostic MRI. A total of 79 children were randomized to a control or an intervention condition. The intervention involved familiarizing the child with the MRI model machine, listing the steps involved in the scan to the child in vivid detail, training the child to stand still for 5min, and conducting several dry runs with a doll or a favorite toy. The study was approved by the Institute ethical committee. The need for sedation was 41% (n = 16) in the control group and this declined to 20% (n = 8) in the intervention group (χ(2) = 4.13; P = 0.04). The relative risk of sedation decreased by 49% in the intervention group as compared to the control group (RR 0.49; 95% CI: 0.24-1.01) and this difference was statistically significant (P = 0.04). The absolute risk difference in sedation use between intervention and control group was 21% (95% CI 1.3%-40.8%). Even on adjusting for age, relative risk of sedation remained significantly lower in children undergoing play therapy as compared to the control (RR 0.57, 95% CI: 0.32-0.98) with P value of 0.04. The use of an MRI customized play therapy with pediatric patients undergoing diagnostic MRI resulted in significant reduction of the use of sedation.