Skip to main content
SpringerLink
Log in

Sedation for Radiological Procedures

  • Chapter
  • First Online:
Pediatric Sedation Outside of the Operating Room

  • 1545 Accesses

Abstract

Pediatric radiological procedures are heterogeneous, varying in duration, level of immobility required for quality imaging results, discomfort involved, and potential patient distress. As such, in addition to the individual patient characteristics to weigh with any sedation, there are distinct sedation considerations for every modality. To help guide sedation providers through this diverse landscape, this chapter will review the relevant literature evaluating different sedation options as well as the unique sedation requirements related to common pediatric radiological procedures—magnetic resonance imaging (MRI), nuclear medicine procedures (MIBG, bone scans, etc.), magnetoencephalography (MEG), computed tomography (CT), voiding cystourethrogram (VCUG)/cystogram, and transthoracic echocardiogram (TTE).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Abbreviations

CLS:

Child life specialist

CT:

Computed tomography

EEG:

Electroencephalogram

IN Dex:

Intranasal dexmedetomidine

IV:

Intravenous

MIBG:

Metaiodobenzylguanidine

MRI:

Magnetic resonance imaging

TTE:

Transthoracic echocardiogram

VCUG:

Voiding cystourethrogram

References

  1. Han SH, Park JW, Choi SI, Kim JY, Lee H, Yoo HJ, et al. Effect of immersive virtual reality education before chest radiography on anxiety and distress among Pediatric patients: a randomized clinical trial. JAMA Pediatr. 2019;173(11):1026–31.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Uffman JC, Tumin D, Raman V, Thung A, Adler B, Tobias JD. MRI utilization and the associated use of sedation and anesthesia in a pediatric ACO. J Am Coll Radiol. 2017;14(7):924–30.

    Article  PubMed  Google Scholar 

  3. Smith-Bindman R, Miglioretti DL, Johnson E, Lee C, Feigelson HS, Flynn M, et al. Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996–2010. JAMA. 2012;307(22).

    Google Scholar 

  4. Jaimes C, Murcia DJ, Miguel K, Defuria C, Sagar P, Gee MS. Identification of quality improvement areas in pediatric MRI from analysis of patient safety reports. Pediatr Radiol. 2018;48(1):66–73.

    Article  PubMed  Google Scholar 

  5. Coté CJ, Wilson S. Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures. Pediatrics. 2019;143(6):e20191000.

    Article  PubMed  Google Scholar 

  6. Dempsey MF, Condon B, Hadley DM. MRI safety review. Seminars in Ultrasound, CT and MRI. 2002;23(5):392–401.

    Article  PubMed  Google Scholar 

  7. Dewachter P, Mouton-Faivre C, Hepner DL. Perioperative anaphylaxis: what should be known? Curr Allergy Asthma Rep. 2015;15(5).

    Google Scholar 

  8. Hertzog JH, Preisberga K, Penfil S. The incidence and nature of allergic and anaphylactic reactions during Pediatric procedural sedation: a report from the Pediatric sedation research consortium. Hosp Pediatr. 2019;9(1):16–23.

    Article  PubMed  Google Scholar 

  9. Rozenfeld MN, Podberesky DJ. Gadolinium-based contrast agents in children. Pediatr Radiol. 2018;48(9):1188–96.

    Article  PubMed  Google Scholar 

  10. Salik I, Hernandez J. Gadolinium induced anaphylaxis under general anesthesia in a patient with sickle cell disease. J Clin Anesth. 2019;54:47.

    Article  PubMed  Google Scholar 

  11. McGuirt D. Alternatives to sedation and general anesthesia in pediatric magnetic resonance imaging: a literature review. Radiol Technol. 2016;88(1):18–26.

    PubMed  Google Scholar 

  12. Jaimes C, Gee MS. Strategies to minimize sedation in pediatric body magnetic resonance imaging. Pediatr Radiol. 2016;46(6):916–27.

    Article  PubMed  Google Scholar 

  13. Thieba C, Frayne A, Walton M, Mah A, Benischek A, Dewey D, et al. Factors associated with successful MRI scanning in unsedated young children. Front Pediatr 2018;6.

    Google Scholar 

  14. Xu HS, Cavaliere RM, Min RJ. Transforming the imaging experience while decreasing sedation rates. J Am Coll Radiol. 2020;17(1 Pt A):46–52.

    Article  PubMed  Google Scholar 

  15. Durand DJ, Young M, Nagy P, Tekes A, Huisman TA. Mandatory child life consultation and its impact on pediatric MRI workflow in an Academic Medical Center. J Am Coll Radiol. 2015;12(6):594–8.

    Article  PubMed  Google Scholar 

  16. De Bie HMA, Boersma M, Wattjes MP, Adriaanse S, Vermeulen RJ, Oostrom KJ, et al. Preparing children with a mock scanner training protocol results in high quality structural and functional MRI scans. Eur J Pediatr. 2010;169(9):1079–85.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Barnea-Goraly N, Weinzimer SA, Ruedy KJ, Mauras N, Beck RW, Marzelli MJ, et al. High success rates of sedation-free brain MRI scanning in young children using simple subject preparation protocols with and without a commercial mock scanner–the diabetes research in children network (DirecNet) experience. Pediatr Radiol. 2014;44(2):181–6.

    Article  PubMed  Google Scholar 

  18. Carter AJ, Greer M-LC, Gray SE, Ware RS. Mock MRI: reducing the need for anaesthesia in children. Pediatr Radiol. 2010;40(8):1368–74.

    Article  PubMed  Google Scholar 

  19. Harned Ii RK, Strain JD. MRI-compatible audio/visual system: impact on pediatric sedation. Pediatr Radiol. 2001;31(4):247–50.

    Article  Google Scholar 

  20. Ahmad R, Hu HH, Krishnamurthy R, Krishnamurthy R. Reducing sedation for pediatric body MRI using accelerated and abbreviated imaging protocols. Pediatr Radiol. 2018;48(1):37–49.

    Article  PubMed  Google Scholar 

  21. Havidich JE, Beach M, Dierdorf SF, Onega T, Suresh G, Cravero JP. Preterm versus term children: analysis of sedation/anesthesia adverse events and longitudinal risk. Pediatrics. 2016;137(3):e20150463.

    Article  PubMed  Google Scholar 

  22. Allegaert K, Van Den Anker JN. Clinical pharmacology in neonates: small size, huge variability. Neonatology. 2014;105(4):344–9.

    Article  CAS  PubMed  Google Scholar 

  23. Mathur AM, Neil JJ, McKinstry RC, Inder TE. Transport, monitoring, and successful brain MR imaging in unsedated neonates. Pediatr Radiol. 2008;38(3):260–4.

    Article  PubMed  Google Scholar 

  24. Windram J, Grosse-Wortmann L, Shariat M, Greer ML, Crawford MW, Yoo SJ. Cardiovascular MRI without sedation or general anesthesia using a feed-and-sleep technique in neonates and infants. Pediatr Radiol. 2012;42(2):183–7.

    Article  PubMed  Google Scholar 

  25. Antonov NK, Ruzal-Shapiro CB, Morel KD, Millar WS, Kashyap S, Lauren CT, et al. Feed and wrap MRI technique in infants. Clin Pediatr. 2017;56(12):1095–103.

    Article  Google Scholar 

  26. Eker HE, Cok OY, Cetinkaya B, Aribogan A. Oral 30% glucose provides sufficient sedation in newborns during MRI. J Anesth. 2017;31(2):206–11.

    Article  PubMed  Google Scholar 

  27. Cravero JP, Blike GT, Beach M, Gallagher SM, Hertzog JH, Havidich JE, et al. Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the pediatric sedation research consortium. Pediatrics. 2006;118(3):1087–96.

    Article  PubMed  Google Scholar 

  28. Couloures KG, Beach M, Cravero JP, Monroe KK, Hertzog JH. Impact of provider specialty on pediatric procedural sedation complication rates. Pediatrics. 2011;127(5):e1154–60.

    Article  PubMed  Google Scholar 

  29. Kamat PP, McCracken CE, Gillespie SE, Fortenberry JD, Stockwell JA, Cravero JP, et al. Pediatric critical care physician-administered procedural sedation using propofol. Pediatr Crit Care Med. 2015;16(1):11–20.

    Article  PubMed  Google Scholar 

  30. Cravero JP, Beach ML, Blike GT, Gallagher SM, Hertzog JH. The incidence and nature of adverse events during pediatric sedation/anesthesia with propofol for procedures outside the operating room: a report from the pediatric sedation research consortium. Anesth Analg. 2009;108(3):795–804.

    Article  CAS  PubMed  Google Scholar 

  31. Srinivasan M, Turmelle M, Depalma LM, Mao J, Carlson DW. Procedural sedation for diagnostic imaging in children by pediatric hospitalists using propofol: analysis of the nature, frequency, and predictors of adverse events and interventions. J Pediatr. 2012;160(5):801–6.e1

    Article  PubMed  Google Scholar 

  32. Jain R, Petrillo-Albarano T, Parks WJ, Linzer JF Sr, Stockwell JA. Efficacy and safety of deep sedation by non-anesthesiologists for cardiac MRI in children. Pediatr Radiol. 2013;43(5):605–11.

    Article  PubMed  Google Scholar 

  33. Monroe KK, Beach M, Reindel R, Badwan L, Couloures KG, Hertzog JH, et al. Analysis of procedural sedation provided by pediatricians. Pediatr Int. 2013;55(1):17–23.

    Article  PubMed  Google Scholar 

  34. Grunwell JR, Marupudi NK, Gupta RV, Travers CD, McCracken CE, Williamson JL, et al. Outcomes following implementation of a pediatric procedural sedation guide for referral to general anesthesia for magnetic resonance imaging studies. Paediatr Anaesth. 2016;26(6):628–36.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Weerink MAS, Struys MMRF, Hannivoort LN, Barends CRM, Absalom AR, Colin P. Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine. Clin Pharmacokinet. 2017;56(8):893–913.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Mason KP, O’Mahony E, Zurakowski D, Libenson MH. Effects of dexmedetomidine sedation on the EEG in children. Paediatr Anaesth. 2009;19(12):1175–83.

    Article  PubMed  Google Scholar 

  37. Andropoulos DB. Effect of Anesthesia on the developing brain: infant and Fetus. Fetal Diagn Ther. 2018;43(1):1–11.

    Article  PubMed  Google Scholar 

  38. Heard CM, Joshi P, Johnson K. Dexmedetomidine for pediatric MRI sedation: a review of a series of cases. Paediatr Anaesth. 2007;17(9):888–92.

    Article  PubMed  Google Scholar 

  39. Phelps JR, Russell A, Lupa MC, McNaull P, Pittenger S, Ricketts K, et al. High-dose dexmedetomidine for noninvasive pediatric procedural sedation and discharge readiness. Paediatr Anaesth. 2015;25(9):877–82.

    Article  PubMed  Google Scholar 

  40. Mason KP, Zurakowski D, Zgleszewski SE, Robson CD, Carrier M, Hickey PR, et al. High dose dexmedetomidine as the sole sedative for pediatric MRI. Paediatr Anaesth. 2008;18(5):403–11.

    Article  PubMed  Google Scholar 

  41. Ahmed SS, Unland T, Slaven JE, Nitu ME. High dose dexmedetomidine: effective as a sole agent sedation for children undergoing MRI. Int J Pediatr. 2015;2015:397372.

    PubMed  PubMed Central  Google Scholar 

  42. Siddappa R, Riggins J, Kariyanna S, Calkins P, Rotta AT. High-dose dexmedetomidine sedation for pediatric MRI. Paediatr Anaesth. 2011;21(2):153–8.

    Article  PubMed  Google Scholar 

  43. Mason KP. Response to Dr. Phelps et al. High-dose dexmedetomidine for noninvasive pediatric procedural sedation and discharge readiness. Paediatr Anaesth. 2015;25(9):963.

    Article  Google Scholar 

  44. Mason KP, Zgleszewski S, Forman RE, Stark C, DiNardo JA. An exaggerated hypertensive response to glycopyrrolate therapy for bradycardia associated with high-dose dexmedetomidine. Anesth Analg. 2009;108(3):906–8.

    Article  PubMed  Google Scholar 

  45. Mason KP, Lonnqvist PA. Bradycardia in perspective-not all reductions in heart rate need immediate intervention. Paediatr Anaesth. 2015;25(1):44–51.

    Article  PubMed  Google Scholar 

  46. Subramanyam R, Cudilo EM, Hossain MM, McAuliffe J, Wu J, Patino M, et al. To pretreat or not to Pretreat: prophylactic anticholinergic administration before dexmedetomidine in pediatric imaging. Anesth Analg. 2015;121(2):479–85.

    Article  CAS  PubMed  Google Scholar 

  47. Mason KP, Zurakowski D, Zgleszewski S, Prescilla R, Fontaine PJ, Dinardo JA. Incidence and predictors of hypertension during high-dose dexmedetomidine sedation for pediatric MRI. Pediatr Anesth. 2010;20(6):516–23.

    Article  Google Scholar 

  48. Sulton C, McCracken C, Simon HK, Hebbar K, Reynolds J, Cravero J, et al. Pediatric procedural sedation using dexmedetomidine: a report from the Pediatric sedation research consortium. Hosp Pediatr. 2016;6(9):536–44.

    Article  PubMed  Google Scholar 

  49. Mahmoud M, Gunter J, Donnelly LF, Wang Y, Nick TG, Sadhasivam S. A comparison of dexmedetomidine with propofol for magnetic resonance imaging sleep studies in children. Anesth Analg. 2009;109(3):745–53.

    Article  CAS  PubMed  Google Scholar 

  50. Poonai N, Spohn J, Vandermeer B, Ali S, Bhatt M, Hendrikx S, et al. Intranasal dexmedetomidine for procedural distress in children: a systematic review. Pediatrics. 2020;145(1):e20191623.

    Article  PubMed  Google Scholar 

  51. Ambi US, Joshi C, Ganeshnavar A, Adarsh E. Intranasal dexmedetomidine for paediatric sedation for diagnostic magnetic resonance imaging studies. Indian J Anaesth. 2012;56(6):587–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Tug A, Hanci A, Turk HS, Aybey F, Isil CT, Sayin P, et al. Comparison of two different intranasal doses of dexmedetomidine in children for magnetic resonance imaging sedation. Paediatr Drugs. 2015;17(6):479–85.

    Article  PubMed  Google Scholar 

  53. Olgun G, Ali MH. Use of intranasal dexmedetomidine as a solo sedative for MRI of infants. Hosp Pediatr. 2018;8(2):68–71.

    Article  Google Scholar 

  54. Sulton C, Kamat P, Mallory M, Reynolds J. The use of intranasal dexmedetomidine and midazolam for sedated magnetic resonance imaging in children: a report from the Pediatric sedation research consortium. Pediatr Emerg Care. 2020;36(3):138–42.

    PubMed  Google Scholar 

  55. Cozzi G, Monasta L, Maximova N, Poropat F, Magnolato A, Sbisa E, et al. Combination of intranasal dexmedetomidine and oral midazolam as sedation for pediatric MRI. Paediatr Anaesth. 2017;27(9):976–7.

    Article  PubMed  Google Scholar 

  56. Boriosi JP, Eickhoff JC, Hollman GA. Safety and efficacy of buccal dexmedetomidine for MRI sedation in school-aged children. Hosp Pediatr. 2019;9(5):348–54.

    Article  PubMed  Google Scholar 

  57. Mason KP, Lubisch NB, Robinson F, Roskos R. Intramuscular dexmedetomidine sedation for pediatric MRI and CT. AJR Am J Roentgenol. 2011;197(3):720–5.

    Article  PubMed  Google Scholar 

  58. Hassan NE, Betz BW, Cole MR, Wincek J, Reischman D, Sanfilippo DJ, et al. Randomized controlled trial for intermittent versus continuous propofol sedation for pediatric brain and spine magnetic resonance imaging studies. Pediatr Crit Care Med. 2011;12(6):e262–5.

    Article  PubMed  Google Scholar 

  59. Chidambaran V, Costandi A, D’Mello A. Propofol: a review of its role in pediatric anesthesia and sedation. CNS Drugs. 2015;29(7):543–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Hasan RA, Shayevitz JR, Patel V. Deep sedation with propofol for children undergoing ambulatory magnetic resonance imaging of the brain: experience from a pediatric intensive care unit. Pediatr Crit Care Med. 2003;4(4):454–8.

    Article  PubMed  Google Scholar 

  61. Pershad J, Wan J, Anghelescu DL. Comparison of propofol with pentobarbital/midazolam/fentanyl sedation for magnetic resonance imaging of the brain in children. Pediatrics. 2007;120(3):e629–e36.

    Article  PubMed  Google Scholar 

  62. Sebe A, Yilmaz HL, Koseoglu Z, Ay MO, Gulen M. Comparison of midazolam and propofol for sedation in pediatric diagnostic imaging studies. Postgrad Med. 2014;126(3):225–30.

    Article  PubMed  Google Scholar 

  63. Machata AM, Willschke H, Kabon B, Kettner SC, Marhofer P. Propofol-based sedation regimen for infants and children undergoing ambulatory magnetic resonance imaging. Br J Anaesth. 2008;101(2):239–43.

    Article  CAS  PubMed  Google Scholar 

  64. Emrath ET, Stockwell JA, McCracken CE, Simon HK, Kamat PP. Provision of deep procedural sedation by a pediatric sedation team at a freestanding imaging center. Pediatr Radiol. 2014;44(8):1020–5.

    Article  PubMed  Google Scholar 

  65. Mallory MD, Baxter AL, Kost SI. Propofol vs pentobarbital for sedation of children undergoing magnetic resonance imaging: results from the pediatric sedation research consortium. Paediatr Anaesth. 2009;19(6):601–11.

    Article  PubMed  Google Scholar 

  66. Ahmed SS, Unland TL, Slaven JE, Nitu ME. Dexmedetomidine versus propofol: is one better than the other for MRI sedation in children? J Pediatr Intensive Care. 2017;6(2):117–22.

    CAS  PubMed  Google Scholar 

  67. Zhou Q, Shen L, Zhang X, Li J, Tang Y. Dexmedetomidine versus propofol on the sedation of pediatric patients during magnetic resonance imaging (MRI) scanning: a meta-analysis of current studies. Oncotarget. 2017;8(60):102468–73.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Fang H, Yang L, Wang X, Zhu H. Clinical efficacy of dexmedetomidine versus propofol in children undergoing magnetic resonance imaging: a meta-analysis. Int J Clin Exp Med. 2015;8(8):11881–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  69. Tang Y, Meng J, Zhang X, Li J, Zhou Q. Comparison of dexmedetomidine with propofol as sedatives for pediatric patients undergoing magnetic resonance imaging: a meta-analysis of randomized controlled trials with trial sequential analysis. Exp Ther Med. 2019;18(3):1775–85.

    CAS  PubMed  PubMed Central  Google Scholar 

  70. Heard C, Burrows F, Johnson K, Joshi P, Houck J, Lerman J. A comparison of dexmedetomidine-midazolam with propofol for maintenance of anesthesia in children undergoing magnetic resonance imaging. Anesth Analg. 2008;107(6):1832–9.

    Article  CAS  PubMed  Google Scholar 

  71. Koroglu A, Teksan H, Sagr O, Yucel A, Toprak HI, Ersoy OM. A comparison of the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging. Anesth Analg. 2006;103(1):63–7.

    Article  CAS  PubMed  Google Scholar 

  72. Jenkins E, Hebbar KB, Karaga KK, Hirsh DA, Fortenberry JD, McCracken CE, et al. Experience with the use of propofol for radiologic imaging in infants younger than 6 months of age. Pediatr Radiol. 2017;47(8):974–83.

    Article  PubMed  Google Scholar 

  73. Nagoshi M, Reddy S, Bell M, Cresencia A, Margolis R, Wetzel R, et al. Low-dose dexmedetomidine as an adjuvant to propofol infusion for children in MRI: a double-cohort study. Pediatr Anesth. 2018;28(7):639–46.

    Article  Google Scholar 

  74. Boriosi JP, Eickhoff JC, Klein KB, Hollman GA. A retrospective comparison of propofol alone to propofol in combination with dexmedetomidine for pediatric 3T MRI sedation. Paediatr Anaesth. 2017;27(1):52–9.

    Article  PubMed  Google Scholar 

  75. Kang R, Shin YH, Gil N-S, Kim KY, Yeo H, Jeong JS. A comparison of the use of propofol alone and propofol with midazolam for pediatric magnetic resonance imaging sedation – a retrospective cohort study. BMC Anesthesiol. 2017;17(1):138.

    Google Scholar 

  76. Schmitz A, Weiss M, Kellenberger C, O’Gorman Tuura R, Klaghofer R, Scheer I, et al. Sedation for magnetic resonance imaging using propofol with or without ketamine at induction in pediatrics-a prospective randomized double-blinded study. Pediatr Anesth. 2018;28(3):264–74.

    Article  Google Scholar 

  77. Kaila R, Chen X, Kannikeswaran N. Postdischarge adverse events related to sedation for diagnostic imaging in children. Pediatr Emerg Care. 2012;28(8):796–801.

    Article  PubMed  Google Scholar 

  78. Teshome G, Belani K, Braun JL, Constantine DR, Gattu RK, Lichenstein R. Comparison of dexmedetomidine with pentobarbital for pediatric MRI sedation. Hosp Pediatr. 2014;4(6):360–5.

    Article  PubMed  Google Scholar 

  79. Malviya S, Voepel-Lewis T, Tait AR, Reynolds PI, Gujar SK, Gebarski SS, et al. Pentobarbital vs chloral hydrate for sedation of children undergoing MRI: efficacy and recovery characteristics. Paediatr Anaesth. 2004;14(7):589–95.

    Article  PubMed  Google Scholar 

  80. Schlatter J, Kabiche S, Sellier N, Fontan JE. Oral pentobarbital suspension for children sedation during MR imaging. Ann Pharm Fr. 2018;76(4):286–90.

    Article  CAS  PubMed  Google Scholar 

  81. Jones NE, Kelleman MS, Simon HK, Stockwell JA, McCracken C, Mallory MD, et al. Evaluation of methohexital as an alternative to propofol in a high volume outpatient pediatric sedation service. Am J Emerg Med. 2017;35(8):1101–5.

    Article  PubMed  Google Scholar 

  82. Nordt SP, Rangan C, Hardmaslani M, Clark RF, Wendler C, Valente M. Pediatric chloral hydrate poisonings and death following outpatient procedural sedation. J Med Toxicol. 2014;10(2):219–22.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Farr KM, Moffett BS, Jones JL, Rogers AP, Chumpitazi CE. Chloral hydrate sedation in a dexmedetomidine era. Hosp Pharm. 2019. https://doi.org/10.1177/0018578719836639.

  84. Grissinger M. Chloral hydrate: is it still being used? Are there safer alternatives? P t. 2019;44(8):444–59.

    PubMed  PubMed Central  Google Scholar 

  85. Cote CJ, Karl HW, Notterman DA, Weinberg JA, McCloskey C. Adverse sedation events in pediatrics: analysis of medications used for sedation. Pediatrics. 2000;106(4):633–44.

    Article  CAS  PubMed  Google Scholar 

  86. Greenberg SB, Faerber EN, Aspinall CL, Adams RC. High-dose chloral hydrate sedation for children undergoing MR imaging: safety and efficacy in relation to age. AJR Am J Roentgenol. 1993;161(3):639–41.

    Article  CAS  PubMed  Google Scholar 

  87. Lee YJ, Kim DK, Kwak YH, Kim HB, Park JH, Jung JH. Analysis of the appropriate age and weight for pediatric patient sedation for magnetic resonance imaging. Am J Emerg Med. 2012;30(7):1189–95.

    Article  PubMed  Google Scholar 

  88. Delgado J, Toro R, Rascovsky S, Arango A, Angel GJ, Calvo V, et al. Chloral hydrate in pediatric magnetic resonance imaging: evaluation of a 10-year sedation experience administered by radiologists. Pediatr Radiol. 2015;45(1):108–14.

    Article  PubMed  Google Scholar 

  89. Fallah R, Fadavi N, Behdad S, Fallah Tafti M. Efficacy of chloral hydrate-hydroxyzine and chloral hydrate-midazolam in pediatric magnetic resonance imaging sedation. Iran J Child Neurol. 2014;8(2):11–7.

    PubMed  PubMed Central  Google Scholar 

  90. Li BL, Yuen VM, Song XR, Ye J, Ni J, Huang JX, et al. Intranasal dexmedetomidine following failed chloral hydrate sedation in children. Anaesthesia. 2014;69(3):240–4.

    Article  CAS  PubMed  Google Scholar 

  91. Zhang W, Fan Y, Zhao T, Chen J, Zhang G, Song X. Median effective dose of intranasal Dexmedetomidine for rescue sedation in pediatric patients undergoing magnetic resonance imaging. Anesthesiology. 2016;125(6):1130–5.

    Article  CAS  PubMed  Google Scholar 

  92. Zhang W, Wang Z, Song X, Fan Y, Tian H, Li B. Comparison of rescue techniques for failed chloral hydrate sedation for magnetic resonance imaging scans--additional chloral hydrate vs intranasal dexmedetomidine. Paediatr Anaesth. 2016;26(3):273–9.

    Article  CAS  PubMed  Google Scholar 

  93. Fong CY, Tay CG, Ong LC, Lai NM. Chloral hydrate as a sedating agent for neurodiagnostic procedures in children. Cochrane Database Syst Rev. 2017;11(11):CD011786.

    PubMed  Google Scholar 

  94. Merola C, Albarracin C, Lebowitz P, Bienkowski RS, Barst SM. An audit of adverse events in children sedated with chloral hydrate or propofol during imaging studies. Paediatr Anaesth. 1995;5(6):375–8.

    Article  CAS  PubMed  Google Scholar 

  95. Davignon MN, Friedlaender E, Cronholm PF, Paciotti B, Levy SE. Parent and provider perspectives on procedural care for children with autism spectrum disorders. J Dev Behav Pediatr. 2014;35(3):207–15.

    Article  PubMed  Google Scholar 

  96. Kamat PP, Karaga MK, Wisniewski BL, McCracken CE, Simon HK, Sidhu R, et al. Outpatient procedural sedation of patients with autism Spectrum disorders for magnetic resonance imaging of the brain using propofol. J Child Neurol. 2018;33(5):313–9.

    Article  PubMed  Google Scholar 

  97. Abulebda K, Louer R, Lutfi R, Ahmed SS. A comparison of safety and efficacy of dexmedetomidine and propofol in children with autism and autism Spectrum disorders undergoing magnetic resonance imaging. J Autism Dev Disord. 2018;48(9):3127–32.

    Article  PubMed  Google Scholar 

  98. Ahmed SS, Unland T, Slaven JE, Nitu ME, Rigby MR. Successful use of intravenous dexmedetomidine for magnetic resonance imaging sedation in autistic children. South Med J. 2014;107(9):559–64.

    Article  CAS  PubMed  Google Scholar 

  99. Lubisch N, Roskos R, Berkenbosch JW. Dexmedetomidine for procedural sedation in children with autism and other behavior disorders. Pediatr Neurol. 2009;41(2):88–94.

    Article  PubMed  Google Scholar 

  100. Awogbemi T, Watson AR, Hiley D, Clarke L. Preparing children for day case nuclear medicine procedures. Nucl Med Commun. 2005;26(10):881–4.

    Article  PubMed  Google Scholar 

  101. Dvory A, Goshen Y, Ruimi S, Bikov S, Halevy R, Koren A. Dream doctor intervention instead of sedation: performing radionuclide scanning without sedation in Young children: a study in 142 patients. J Altern Complement Med. 2016;22(5):408–12.

    Article  PubMed  Google Scholar 

  102. Roberts EG, Shulkin BL. Technical issues in performing PET studies in pediatric patients. J Nucl Med Technol. 2004;32(1):5–9. quiz 10-1

    PubMed  Google Scholar 

  103. Weiss S. Sedation of pediatric patients for nuclear medicine procedures. Semin Nucl Med. 1993;23(3):190–8.

    Article  CAS  PubMed  Google Scholar 

  104. Mason KP, Robinson F, Fontaine P, Prescilla R. Dexmedetomidine offers an option for safe and effective sedation for nuclear medicine imaging in children. Radiology. 2013;267(3):911–7.

    Article  PubMed  Google Scholar 

  105. Wagner KJ, Schulz CM, Sprenger T, Pieper T, Heuser F, Hohmann CP, et al. Comparing propofol versus sevoflurane anesthesia for epileptogenic focus detection during positron emission tomography in pediatric patients. Minerva Anestesiol. 2013;79(11):1264–8.

    CAS  PubMed  Google Scholar 

  106. Ahmed S, Slaven J, Nitu M, Hicks S. Intermittent bolus versus continuous infusion of Propofol for deep sedation during ABR/nuclear medicine studies. J Pediatr Intensive Care. 2017;06(03):176–81.

    Article  Google Scholar 

  107. Szmuk P, Kee S, Pivalizza EG, Warters RD, Abramson DC, Ezri T. Anaesthesia for magnetoencephalography in children with intractable seizures. Pediatr Anesth. 2003;13(9):811–7.

    Article  Google Scholar 

  108. Konig MW, Mahmoud MA, Fujiwara H, Hemasilpin N, Lee KH, Rose DF. Influence of anesthetic management on quality of magnetoencephalography scan data in pediatric patients: a case series. Paediatr Anaesth. 2009;19(5):507–12.

    Article  PubMed  Google Scholar 

  109. Birg L, Narayana S, Rezaie R, Papanicolaou A. Technical tips: MEG and EEG with sedation. Neurodiagn J. 2013;53(3):229–40.

    Article  PubMed  Google Scholar 

  110. Rezaie R, Narayana S, Schiller K, Birg L, Wheless JW, Boop FA, et al. Assessment of hemispheric dominance for receptive language in pediatric patients under sedation using magnetoencephalography. Front Hum Neurosci. 2014;8:657.

    Article  PubMed  PubMed Central  Google Scholar 

  111. Tenney JR, Miller JW, Rose DF. Intranasal dexmedetomidine for sedation during Magnetoencephalography. J Clin Neurophysiol. 2019;36(5):371–4.

    Article  PubMed  Google Scholar 

  112. Harned RK 2nd, Heran MKS, Patel M, Barnacle A, Cahill AM, Braswell L, et al. Challenges and opportunities for continued success and growth of Pediatric interventional radiology: a communique from the society for pediatric interventional radiology. AJR Am J Roentgenol. 2018;211(4):740–3.

    Article  PubMed  Google Scholar 

  113. Lederer W, Grams A, Helbok R, Stichlberger M, Bale R, Wiedermann FJ. Standards of anesthesiology practice during neuroradiological interventions. Open Med. 2016;11(1):270–8.

    Article  Google Scholar 

  114. Lang EV, Viegas J, Bleeker C, Bruhn J, Van Geffen G-J. Helping children cope with medical tests and interventions. J Radiol Nurs. 2017;36(1):44–50.

    Article  PubMed  PubMed Central  Google Scholar 

  115. Weiser G, Gross I, Verstandig A, Farkas A. Pediatric sedation in vascular malformations interventions by a non-anesthesiologist-feasibility and safety. Br J Radiol. 2020;93(1106):20190781.

    Article  PubMed  PubMed Central  Google Scholar 

  116. Diament MJ, Boechat MI, Kangarloo H. Interventional radiology in infants and children: clinical and technical aspects. Radiology. 1985;154(2):359–61.

    Article  CAS  PubMed  Google Scholar 

  117. Alexander M. Managing patient stress in pediatric radiology. Radiol Technol. 2012;83(6):549–60.

    PubMed  Google Scholar 

  118. Sanborn PA, Michna E, Zurakowski D, Burrows PE, Fontaine PJ, Connor L, et al. Adverse cardiovascular and respiratory events during sedation of Pediatric patients for imaging examinations. Radiology. 2005;237(1):288–94.

    Article  PubMed  Google Scholar 

  119. Erden IA, Pamuk AG, Akinci SB, Koseoglu A, Aypar U. Comparison of propofol-fentanyl with propofol-fentanyl-ketamine combination in pediatric patients undergoing interventional radiology procedures. Paediatr Anaesth. 2009;19(5):500–6.

    Article  PubMed  Google Scholar 

  120. Mason KP, Michna E, DiNardo JA, Zurakowski D, Karian VE, Connor L, et al. Evolution of a protocol for ketamine-induced sedation as an alternative to general anesthesia for interventional radiologic procedures in pediatric patients. Radiology. 2002;225(2):457–65.

    Article  PubMed  Google Scholar 

  121. Sacchetti A, Carraccio C, Giardino A, Harris RH. Sedation for pediatric CT scanning: is radiology becoming a drug-free zone? Pediatr Emerg Care. 2005;21(5):295–7.

    Article  PubMed  Google Scholar 

  122. Dorneles CM, Pacini GS, Zanon M, Altmayer S, Watte G, Barros MC, et al. Ultra-low-dose chest computed tomography without anesthesia in the assessment of pediatric pulmonary diseases. J Pediatr (Rio J). 2020;96(1):92–9.

    Google Scholar 

  123. Kino A, Zucker EJ, Honkanen A, Kneebone J, Wang J, Chan F, et al. Ultrafast pediatric chest computed tomography: comparison of free-breathing vs. breath-hold imaging with and without anesthesia in young children. Pediatr Radiol. 2019;49(3):301–7.

    Article  PubMed  Google Scholar 

  124. Lindberg DM, Stence NV, Grubenhoff JA, Lewis T, Mirsky DM, Miller AL, et al. Feasibility and accuracy of fast MRI versus CT for traumatic brain injury in Young children. Pediatrics. 2019;144(4):e20190419.

    Article  PubMed  Google Scholar 

  125. Callahan MJ, MacDougall RD, Bixby SD, Voss SD, Robertson RL, Cravero JP. Ionizing radiation from computed tomography versus anesthesia for magnetic resonance imaging in infants and children: patient safety considerations. Pediatr Radiol. 2018;48(1):21–30.

    Article  PubMed  Google Scholar 

  126. Kharazmi SA, Kamat PP, Simoneaux SF, Simon HK. Violating traditional NPO guidelines with PO contrast before sedation for computed tomography. Pediatr Emerg Care. 2013;29(9):979–81.

    Article  PubMed  Google Scholar 

  127. Berger-Achituv S, Zissin R, Shenkman Z, Gutermacher M, Erez I. Gastric emptying time of oral contrast material in children and adolescents undergoing abdominal computed tomography. J Pediatr Gastroenterol Nutr. 2010;51(1):31–4.

    Article  PubMed  Google Scholar 

  128. Mahmoud M, McAuliffe J. Sedation dilemmas for computed tomography with oral contrast in children. Pediatr Emerg Care. 2014;30(5):372.

    Article  PubMed  Google Scholar 

  129. Anderson RE, Osborn AG. Efficacy of simple sedation of pediatric computed tomography. Radiology. 1977;124(3):739–40.

    Article  CAS  PubMed  Google Scholar 

  130. Keeter S, Benator RM, Weinberg SM, Hartenberg MA. Sedation in pediatric CT: national survey of current practice. Radiology. 1990;175(3):745–52.

    Article  CAS  PubMed  Google Scholar 

  131. Vade A, Sukhani R, Dolenga M, Habisohn-Schuck C. Chloral hydrate sedation of children undergoing CT and MR imaging: safety as judged by American Academy of Pediatrics guidelines. Am J Roentgenol. 1995;165(4):905–9.

    Article  CAS  Google Scholar 

  132. Mason KP, Sanborn P, Zurakowski D, Karian VE, Connor L, Fontaine PJ, et al. Superiority of pentobarbital versus chloral hydrate for sedation in infants during imaging. Radiology. 2004;230(2):537–42.

    Article  PubMed  Google Scholar 

  133. Kienstra AJ, Ward MA, Sasan F, Hunter J, Morriss MC, Macias CG. Etomidate versus pentobarbital for sedation of children for head and neck CT imaging. Pediatr Emerg Care. 2004;20(8):499–506.

    Article  PubMed  Google Scholar 

  134. Baxter AL, Mallory MD, Spandorfer PR, Sharma S, Freilich SH, Cravero J. Etomidate versus pentobarbital for computed tomography sedations: report from the pediatric sedation research consortium. Pediatr Emerg Care. 2007;23(10):690–5.

    Article  PubMed  Google Scholar 

  135. Mason KP, Zgleszewski SE, Dearden JL, Dumont RS, Pirich MA, Stark CD, et al. Dexmedetomidine for pediatric sedation for computed tomography imaging studies. Anesth Analg. 2006;103(1):57–62, table of contents

    Article  CAS  PubMed  Google Scholar 

  136. Mason KP, Prescilla R, Fontaine PJ, Zurakowski D. Pediatric CT sedation: comparison of dexmedetomidine and pentobarbital. AJR Am J Roentgenol. 2011;196(2):W194–8.

    Article  PubMed  Google Scholar 

  137. Zgleszewski SE, Zurakowski D, Fontaine PJ, D’Angelo M, Mason KP. Is propofol a safe alternative to pentobarbital for sedation during pediatric diagnostic CT? Radiology. 2008;247(2):528–34.

    Article  PubMed  Google Scholar 

  138. Mekitarian Filho E, Robinson F, de Carvalho WB, Gilio AE, Mason KP. Intranasal dexmedetomidine for sedation for pediatric computed tomography imaging. J Pediatr. 2015;166(5):1313–5. e1

    Article  CAS  PubMed  Google Scholar 

  139. Yuen VM, Li BL, Cheuk DK, Leung MKM, Hui TWC, Wong IC, et al. A randomised controlled trial of oral chloral hydrate vs. intranasal dexmedetomidine before computerised tomography in children. Anaesthesia. 2017;72(10):1191–5.

    Article  CAS  PubMed  Google Scholar 

  140. Yuen VM, Cheuk DK, Hui TW, Wong IC, Lam WW, Irwin MG. Oral chloral hydrate versus intranasal dexmedetomidine for sedation of children undergoing computed tomography: a multicentre study. Hong Kong Med J. 2019;25 Suppl 3(1):27–9.

    CAS  PubMed  Google Scholar 

  141. Lami RO, Pereira AC. Transmucosal dexmedetomidine for computed tomography sedation. Paediatr Anaesth. 2008;18(4):349–78.

    Article  PubMed  Google Scholar 

  142. Singh R, Kumar N, Vajifdar H. Midazolam as a sole sedative for computed tomography imaging in pediatric patients. Paediatr Anaesth. 2009;19(9):899–904.

    Article  PubMed  Google Scholar 

  143. Mekitarian Filho E, De Carvalho WB, Gilio AE, Robinson F, Mason KP. Aerosolized intranasal midazolam for safe and effective sedation for quality computed tomography imaging in infants and children. J Pediatr. 2013;163(4):1217–9.

    Article  CAS  PubMed  Google Scholar 

  144. Fallah R, Nakhaei MH, Behdad S, Moghaddam RN, Shamszadeh A. Oral chloral hydrate vs. intranasal midazolam for sedation during computerized tomography. Indian Pediatr. 2013;50(2):233–5.

    Article  PubMed  Google Scholar 

  145. Ghai B, Jain K, Saxena AK, Bhatia N, Sodhi KS. Comparison of oral midazolam with intranasal dexmedetomidine premedication for children undergoing CT imaging: a randomized, double-blind, and controlled study. Pediatr Anesth. 2017;27(1):37–44.

    Article  Google Scholar 

  146. Barzegari H, Zohrevandi B, Masoumi K, Forouzan A, Darian AA, Khosravi S. Comparison of oral midazolam and promethazine with oral midazolam alone for sedating children during computed tomography. Emerg (Tehran). 2015;3(3):109–13.

    Google Scholar 

  147. Majidinejad S, Taherian K, Esmailian M, Khazaei M, Samaie V. Oral midazolam-ketamine versus midazolam alone for procedural sedation of children undergoing computed tomography; a randomized clinical trial. Emerg (Tehran). 2015;3(2):64–9.

    Google Scholar 

  148. Tsze DS, Mallory MD, Cravero JP. Practice patterns and adverse events of nitrous oxide sedation and analgesia: a report from the Pediatric sedation research consortium. J Pediatr. 2016;169:260–5. e2

    Article  CAS  PubMed  Google Scholar 

  149. Farrell MK, Drake GJ, Rucker D, Finkelstein M, Zier JL. Creation of a registered nurse-administered nitrous oxide sedation program for radiology and beyond. Pediatr Nurs. 2008;34(1):29–35; quiz -6

    PubMed  Google Scholar 

  150. Blumberg K. Sedation and the VCUG. Pediatr Radiol. 2012;42(3):290–2.

    Article  PubMed  Google Scholar 

  151. Thacker PG, Collins HR, Hill J. Distress experienced during pediatric VCUGs - a granular, prospective assessment using the brief behavioral distress scale. Pediatr Radiol. 2016;46(5):660–5.

    Article  PubMed  Google Scholar 

  152. Giramonti KM, Fox JK, LaRaia DK, Halpern LF, Dangman BC, Kogan BA. Is parental anxiety and coping associated with girls’ distress during a VCUG? Preliminary findings. J Pediatr Urol. 2012;8(4):405–9.

    Article  PubMed  Google Scholar 

  153. Gerard LL, Cooper CS, Duethman KS, Gordley BM, Kleiber CM. Effectiveness of lidocaine lubricant for discomfort during pediatric urethral catheterization. J Urol. 2003;170(2 Pt 1):564–7.

    Article  CAS  PubMed  Google Scholar 

  154. Mularoni PP, Cohen LL, DeGuzman M, Mennuti-Washburn J, Greenwald M, Simon HK. A randomized clinical trial of lidocaine gel for reducing infant distress during urethral catheterization. Pediatr Emerg Care. 2009;25(7):439–43.

    Article  PubMed  Google Scholar 

  155. Boots BK, Edmundson EE. A controlled, randomised trial comparing single to multiple application lidocaine analgesia in paediatric patients undergoing urethral catheterisation procedures. J Clin Nurs. 2010;19(5–6):744–8.

    Article  PubMed  Google Scholar 

  156. Poonai N, Li J, Langford C, Lepore N, Taddio A, Gerges S, et al. Intraurethral Lidocaine for urethral catheterization in children: a randomized controlled trial. Pediatrics. 2015;136(4):e879–86.

    Article  PubMed  Google Scholar 

  157. Frimberger D, Mercado-Deane M-G. Establishing a standard protocol for the voiding cystourethrography. Pediatrics. 2016;138(5):e20162590.

    Article  PubMed  Google Scholar 

  158. Merguerian PA, Corbett ST, Cravero J. Voiding ability using propofol sedation in children undergoing voiding cystourethrograms: a retrospective analysis. J Urol. 2006;176(1):299–302.

    Article  PubMed  Google Scholar 

  159. Bates DG. VCUG and the recurring question of sedation: preparation and catheterization technique are the key. Pediatr Radiol. 2012;42(3):285–9.

    Article  PubMed  Google Scholar 

  160. Keidan I, Zaslansky R, Weinberg M, Ben-Shlush A, Jacobson JM, Augarten A, et al. Sedation during voiding cystourethrography: comparison of the efficacy and safety of using oral midazolam and continuous flow nitrous oxide. J Urol. 2005;174(4 Pt 2):1598–600. discussion 601

    Article  PubMed  Google Scholar 

  161. Herd DW. Anxiety in children undergoing VCUG: sedation or no sedation? Adv Urol. 2008;2008:1–12.

    Article  Google Scholar 

  162. Stokland E, Andreasson S, Jacobsson B, Jodal U, Ljung B. Sedation with midazolam for voiding cystourethrography in children: a randomised double-blind study. Pediatr Radiol. 2003;33(4):247–9.

    Article  PubMed  Google Scholar 

  163. Elder JS, Longenecker R. Premedication with oral midazolam for voiding cystourethrography in children: safety and efficacy. AJR Am J Roentgenol. 1995;164(5):1229–32.

    Article  CAS  PubMed  Google Scholar 

  164. Alizadeh A, Naseri M, Ravanshad Y, Sorouri S, Banihassan M, Azarfar A. Use of sedative drugs at reducing the side effects of voiding cystourethrography in children. J Res Med Sci. 2017;22:42.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  165. Zier JL, Kvam KA, Kurachek SC, Finkelstein M. Sedation with nitrous oxide compared with no sedation during catheterization for urologic imaging in children. Pediatr Radiol. 2007;37(7):678–84.

    Article  PubMed  Google Scholar 

  166. Stern KWD, Gauvreau K, Geva T, Benavidez OJ. The impact of procedural sedation on diagnostic errors in pediatric echocardiography. J Am Soc Echocardiogr. 2014;27(9):949–55.

    Article  PubMed  PubMed Central  Google Scholar 

  167. Stern KWD, Chen C, Cohen HW, Mahgerefteh J, Chambers SA, Lopez L. Unplanned repeat echocardiography with sedation in children: patient risk factors. Pediatr Cardiol. 2016;37(6):1057–63.

    Article  PubMed  Google Scholar 

  168. Lorenzoni RP 3rd, Choi J, Choueiter NF, Munjal IM, Katyal C, Stern KWD. Predictors of inadequate initial echocardiography in suspected Kawasaki disease: criteria for sedation. Congenit Heart Dis. 2018;13(3):470–5.

    Article  PubMed  Google Scholar 

  169. Heistein LC. Chloral hydrate sedation for pediatric echocardiography: physiologic responses, adverse events, and risk factors. Pediatrics. 2006;117(3):e434–e41.

    Article  PubMed  Google Scholar 

  170. Napoli KL, Ingall CG, Martin GR. Safety and efficacy of chloral hydrate sedation in children undergoing echocardiography. J Pediatr. 1996;129(2):287–91.

    Article  CAS  PubMed  Google Scholar 

  171. Hill GD, Walbergh DB, Frommelt PC. Efficacy of reconstituted oral chloral hydrate from crystals for echocardiography sedation. J Am Soc Echocardiogr. 2016;29(4):337–40.

    Article  PubMed  PubMed Central  Google Scholar 

  172. Wheeler DS, Jensen RA, Poss WB. A randomized, blinded comparison of chloral hydrate and midazolam sedation in children undergoing echocardiography. Clin Pediatr (Phila). 2001;40(7):381–7.

    Article  CAS  Google Scholar 

  173. Warden CN, Bernard PK, Kimball TR. The efficacy and safety of oral pentobarbital sedation in pediatric echocardiography. J Am Soc Echocardiogr. 2010;23(1):33–7.

    Article  PubMed  Google Scholar 

  174. Ganigara M, Srivastava S, Malik P, Fong S, Ko H, Parness I, et al. Comparison of chloral hydrate and pentobarbital sedation for pediatric echocardiography. Echocardiography. 2019;36(4):766–9.

    Article  PubMed  Google Scholar 

  175. Li BL, Ni J, Huang JX, Zhang N, Song XR, Yuen VM. Intranasal dexmedetomidine for sedation in children undergoing transthoracic echocardiography study—a prospective observational study. Paediatr Anaesth. 2015;25(9):891–6.

    Article  PubMed  Google Scholar 

  176. Miller JW, Divanovic AA, Hossain MM, Mahmoud MA, Loepke AW. Dosing and efficacy of intranasal dexmedetomidine sedation for pediatric transthoracic echocardiography: a retrospective study. Can J Anesth/J canadien d’anesthésie. 2016;63(7):834–41.

    Article  Google Scholar 

  177. Yu Q, Liu Y, Sun M, Zhang J, Zhao Y, Liu F, et al. Median effective dose of intranasal dexmedetomidine sedation for transthoracic echocardiography in pediatric patients with noncyanotic congenital heart disease: an up-and-down sequential allocation trial. Paediatr Anaesth. 2017;27(11):1108–14.

    Article  PubMed  Google Scholar 

  178. Liu Y, Yu Q, Sun M, Li S, Zhang J, Lei Y, et al. Median effective dose of intranasal dexmedetomidine sedation for transthoracic echocardiography examination in postcardiac surgery and normal children: an up-and-down sequential allocation trial. Eur J Anaesthesiol. 2018;35(1):43–8.

    Article  CAS  PubMed  Google Scholar 

  179. Yang F, Li S, Shi Y, Liu L, Ye M, Zhang J, et al. Fifty percent effective dose of intranasal dexmedetomidine sedation for transthoracic echocardiography in children with cyanotic and acyanotic congenital heart disease. J Cardiothorac Vasc Anesth. 2020;34(4):966.

    Article  CAS  PubMed  Google Scholar 

  180. Gu H-B, Song Y-A, Bai J. Median effective dose of intranasal dexmedetomidine for transthoracic echocardiography in children with Kawasaki disease who have a history of repeated sedation. Med Sci Monit. 2019;25:381–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  181. Miller J, Xue B, Hossain M, Zhang MZ, Loepke A, Kurth D. Comparison of dexmedetomidine and chloral hydrate sedation for transthoracic echocardiography in infants and toddlers: a randomized clinical trial. Paediatr Anaesth. 2016;26(3):266–72.

    Article  PubMed  Google Scholar 

  182. Miller JW, Ding L, Gunter JB, Lam JE, Lin EP, Paquin JR, et al. Comparison of intranasal dexmedetomidine and oral pentobarbital sedation for transthoracic echocardiography in infants and toddlers: a prospective, randomized, double-blind trial. Anesth Analg. 2018;126(6):2009–16.

    Article  CAS  PubMed  Google Scholar 

  183. Fett J, Hackbarth R, Boville BM, Olivero AD, Davis AT, Winters JW. Comparative effectiveness of intranasal dexmedetomidine-midazolam versus oral chloral hydrate targeting moderate sedation during pediatric transthoracic echocardiograms. J Pediatr Intensive Care. 2017;6(3):182–7.

    Article  PubMed  Google Scholar 

  184. Alp H, Elmaci AM, Alp EK, Say B. Comparison of intranasal midazolam, intranasal ketamine, and oral chloral hydrate for conscious sedation during paediatric echocardiography: results of a prospective randomised study. Cardiol Young. 2019;29(9):1189–95.

    Article  PubMed  Google Scholar 

  185. Liu J, Du M, Liu L, Cao F, Xu Y. Sedation effects of intranasal dexmedetomidine combined with ketamine and risk factors for sedation failure in young children during transthoracic echocardiography. Pediatr Anesth. 2019;29(1):77–84.

    Article  Google Scholar 

  186. Sun M, Liu H, Yu Q, Liu Y, Zhang J, Lei Y, et al. A comparison of intranasal dexmedetomidine and dexmedetomidine - ketamine combination sedation for transthoracic echocardiography in pediatric patients with congenital heart disease: a randomized controlled trial. J Cardiothorac Vasc Anesth. 2020;34(6):1550–5.

    Article  CAS  PubMed  Google Scholar 

  187. Nicolson SC, Montenegro LM, Cohen MS, O’Neill D, Calfin D, Jones LA, et al. A comparison of the efficacy and safety of chloral hydrate versus inhaled anesthesia for sedating infants and toddlers for transthoracic echocardiograms. J Am Soc Echocardiogr. 2010;23(1):38–42.

    Article  PubMed  Google Scholar 

  188. Lewanda AF, Matisoff A, Revenis M, Harahsheh A, Futterman C, Nino G, et al. Preoperative evaluation and comprehensive risk assessment for children with down syndrome. Paediatr Anaesth. 2016;26(4):356–62.

    Article  PubMed  Google Scholar 

  189. Ueno K, Ninomiya Y, Shiokawa N, Hazeki D, Eguchi T, Kawano Y. Dexmedetomidine is associated with an increased incidence of bradycardia in patients with trisomy 21 after surgery for congenital heart disease. Pediatr Cardiol. 2016;37(7):1228–34.

    Article  PubMed  Google Scholar 

  190. Miller J, Ding L, Spaeth J, Lam J, Paquin J, Lin E, et al. Sedation methods for transthoracic echocardiography in children with trisomy 21-a retrospective study. Paediatr Anaesth. 2017;27(5):531–9.

    Article  PubMed  Google Scholar 

  191. Scherrer PD, Mallory MD, Cravero JP, Lowrie L, Hertzog JH, Berkenbosch JW. The impact of obesity on pediatric procedural sedation-related outcomes: results from the pediatric sedation research consortium. Paediatr Anaesth. 2015;25(7):689–97.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Pediatrics and Anesthesiology, Perioperative and Pain Medicine, Texas Children’s Hospital, Houston, TX, USA

    Amber P. Rogers

  2. Departments of Pediatrics and Anesthesiology, Baylor College of Medicine, Houston, TX, USA

    Amber P. Rogers

Authors
  1. Amber P. Rogers
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amber P. Rogers .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, Harvard Medical School, Boston, MA, USA

    Keira P. Mason, MD

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Rogers, A.P. (2021). Sedation for Radiological Procedures. In: Mason, MD, K.P. (eds) Pediatric Sedation Outside of the Operating Room. Springer, Cham. https://doi.org/10.1007/978-3-030-58406-1_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-58406-1_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-58405-4

  • Online ISBN: 978-3-030-58406-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation