Sedation and General Anesthesia in Diagnostic Pediatric Imaging

Abstract

Abstract Objective In this article we will try and provide a comprehensive literature review on the use of sedation and general anesthesia (SAGA) in pediatric population for diagnostic studies and the salient differences in practices worldwide particularly with regards to the practice differences in developed versus developing countries. Methods The key articles we obtained were primarily from Indian Journal of Anesthesia, Local NHS Trust protocols, PubMed, MEDLINE, NICE Evidence, UptoDate (Wolters Kluwer), and The Cochrane Library. Results In the last two decades pediatric radiology has seen a huge increase in volume of procedures with a proportional increase in SAGA. The duration being dependent on the modality (for example, few minutes for computed tomography scan and up to an hour for magnetic resonance imaging particularly if there are multiple studies). SAGA has an extensive list of adverse effects that could be due to the underlying drug or due to wrong patient selection. The principles for safe use of the drugs remain the same just like any other medical or surgical procedure and include meticulous assessments of children and ruling out the contraindications, obtaining parental consent, deciding the drugs which can be given, ascertain the duration of procedure after communication with the radiologist, monitor closely before, during, and after the procedure, discharge, and after the discharge criteria are met. All the above criteria depend on the local guidelines and therefore vary from not only one country to the other but also from one institution to the other within the same country. Conclusion As expected, the SAGA techniques, drugs, and personnel involved in delivering the care vary from country to country. However, the final and desired outcome remains the same that is to deliver safe care with acquisition of optimal images that serve the purpose of arriving at the correct diagnosis.