Melatonin as an alternative sedation method during magnetic resonance imaging in preschool children with musculoskeletal problems
Magnetic resonance imaging (MRI) in preschool children is often challenging due to excessive motion artifacts. Sedation or general anesthesia (GA) is commonly used to prevent children from moving in the MRI scanner, with increased risk for cardiopulmonary complications and requirement for skilled personnel. Herein, we investigated whether oral melatonin, a natural hormone implicated in circadian rhythm regulation, could be used as an alternative sedation method prior to the MRI in preschool children with musculoskeletal problems. Fifteen children with suspected juvenile idiopathic arthritis underwent a total of 16 MRI examinations following administration of 10 mg of oral melatonin; satisfactory images were obtained in all but one case, with no adverse events.
What is Known:
• Magnetic resonance imaging (MRI) is a well-recognized diagnostic method to visualize synovial inflammation and changes of cartilage and bone in juvenile idiopathic arthritis.
• MRI examination requires sedation or general anesthesia to ensure immobility in children who are uncooperative.
What is New:
• Melatonin without sleep deprivation is efficacious and safe alternative to conventional sedation and general anesthesia before the musculoskeletal contrast-enhanced MRI in preschool children with JIA with timely insertion of intravenous cannula.
KeywordsMRI Sedation Melatonin Juvenile idiopathic arthritis
Juvenile idiopathic arthritis
Magnetic resonance imaging
Agneza Marija Pasini: Dr. Pasini conceptualized and drafted the initial manuscript, approved the final manuscript.
Josip Marjanović: Dr. Marjanović helped with the radiologic procedures and findings and making the diagnosis, writing the initial manuscript, and critically revised the manuscript.
Goran Roić: Dr. Roić helped with the radiologic procedures and findings and making the diagnosis, writing the initial manuscript, and critically revised the manuscript.
Nikola Dukarić: Dr. Dukarić helped with the radiologic procedures and findings and making the diagnosis, writing the initial manuscript.
Ana Tripalo Batoš: Dr. Tripalo Batoš helped with the radiologic findings and making the diagnosis, writing the initial manuscript.
Zoran Bahtijarević: Dr. Bahtijarević was involved in making the diagnosis, follow-up of the patient, and writing the initial manuscript.
Alenka Gagro: Dr. Gagro conceptualized initial manuscript, critically revised the manuscript, approved the final manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Colebatch-Bourn AN, Edwards CJ, Collado P, D'Agostino MA, Hemke R, Jousse-Joulin S, Maas M, Martini A, Naredo E, Østergaard M et al (2015) EULAR-PReS points to consider for the use of imaging in the diagnosis and management of juvenile idiopathic arthritis in clinical practice. Ann Rheum Dis 74(11):1946–1957. https://doi.org/10.1136/annrheumdis-2015-207892 CrossRefPubMedGoogle Scholar
- 5.de Bie HM, Boersma M, Wattjes MP, Adriaanse S, Vermeulen RJ, Oostrom KJ, Huisman J, Veltman DJ, Delemarre-Van de Waal HA (2010) Preparing children with a mock scanner training protocol results in high quality structural and functional MRI scans. Eur J Pediatr 169(9):1079–1085. https://doi.org/10.1007/s00431-010-1181-z CrossRefPubMedPubMedCentralGoogle Scholar