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British Journal of Radiology 74 (2001),875 © 2001 The British Institute of Radiology

Correspondence

Sedation, safety and MRI

The Editor—Sir,

Sedation in paediatric practice is very commonly used and its safety has recently come under close scrutiny. The recent commentary [1] in this journal raises a number of practical issues relating to sedation and MRI, but it does not give a balanced view.

There are many papers giving safe sedation regimens, including one published previously in the BJR [2], with low complication rates emphasizing the importance of patient selection and careful monitoring during sedation. As far as we are aware, no comparative study of sedation vs anaesthesia has been undertaken. As significant complications are uncommon, the size of any randomized study would need to be so large that it would probably not be practicable.

There is even disagreement between anaesthetists as to what is acceptable. Laurence [1] advocates anaesthetist-led sedation, whereas Bray [3] advocates anaesthesia. He consider general anaesthesia with paralysis intubation and ventilation to be essential.

What is clear is that any move towards the ideals advocated in the papers mentioned must be preceded by employment and training of appropriate staff, because without this there is a danger of extended waiting times and a potential for important diagnoses to be delayed to the detriment of the patient.

Yours etc.,

D Pilling, L Abernethy, N Wright and H Carty

Alder Hey Children's Hospital, Royal Liverpool Children's NHS Trust, Eaton Road, Liverpool L12 2AP, UK

Footnotes

See the author's reply on page 875

Received for publication July 21, 2000. Accepted for publication October 31, 2000.

References

  1. Laurence AS. Sedation, safetey and MRI. Br J Radiol 2000;73:575–7.[Medline]
  2. Simpson JH, West CD, Law PJ. Pediatric sedation for CT scanning: the safety and efficacy of quinalbarbitone in a district general hospital setting. Br J Radiol 2000;73:7–9.[Abstract]
  3. Bray RJ. Commentary. In: Lawson GR. Controversy: Sedation of children for magnetic resonance imaging. Arch Dis Child 2000;82:150–3.[Free Full Text]




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