{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:39:08Z","timestamp":1790185148462,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T00:00:00Z","timestamp":1624320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Each year, hundreds of thousands of children require sedation\/anesthesia to facilitate MRI scans. Anesthetic techniques for accomplishing sedation\/anesthesia vary widely between institutions and providers, with unclear implications for patient safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We sought to establish trends in anesthetic practice for pediatric MRI sedation\/anesthesia across a 7\u2010year period and determine rates of adverse events, considering technique used, age, and ASA physical classification status (ASA\u2010PS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using established data resources, we analyzed 24\u00a0052 anesthetics performed by anesthesiologists for MRI scans between 5\/1\/2013 and 12\/31\/2019 on patients less than 18\u00a0years old, focusing on medications used, trends of use, and associated adverse events. Adverse events (hypoxia, hypotension, bradycardia) were defined by deviation from age norms and accessed via the electronic anesthetic record database. The Cochran\u2010Armitage test was used to assess trends over time in categorical data, and one\u2010way ANOVA was used to analyze continuous data. Multivariable logistic regression analysis was implemented to determine the independent associations between anesthetic technique and adverse events while adjusting for age, ASA\u2010PS, and weight.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The most significant trends noted were a decrease in \u201cpropofol\u2010only\u201d anesthetic techniques and an increase in propofol and dexmedetomidine combination techniques. Mild desaturation (80\u201389% SpO\n                      <jats:sub>2<\/jats:sub>\n                      ) occurred in 4.22% of cases with more significant hypoxia much rarer (0.44% of cases having desaturation &lt;70% SpO\n                      <jats:sub>2<\/jats:sub>\n                      ). Bradycardia occurred in 2.39% of cases and hypotension in 1.75% of cases. Major adverse events were rare.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We provide the largest report of the nature of MRI sedation\/anesthesia as practiced by anesthesiologists in a large children's hospital. We demonstrate that, even in a large system, anesthetic techniques are pliable and shift significantly over time. Our data also support a high level of safety within our system, despite a case mix likely higher in risk than those in most of the previously published studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pan.14225","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T20:30:06Z","timestamp":1621974606000},"page":"953-961","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Trends in Pediatric MRI sedation\/anesthesia at a tertiary medical center over time"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1435-1974","authenticated-orcid":false,"given":"Amy E.","family":"Vinson","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Critical Care &amp; Pain Medicine Boston Children\u2019s Hospital &amp; Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2667-9344","authenticated-orcid":false,"given":"James","family":"Peyton","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Critical Care &amp; Pain Medicine Boston Children\u2019s Hospital &amp; Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kordun","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Critical Care &amp; Pain Medicine Boston Children\u2019s Hospital &amp; Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Staffa","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Critical Care &amp; Pain Medicine Boston Children\u2019s Hospital &amp; Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0629-6511","authenticated-orcid":false,"given":"Joseph","family":"Cravero","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Critical Care &amp; Pain Medicine Boston Children\u2019s Hospital &amp; Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e31818fc334"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000504"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2006.02045.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-020-03916-w"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13041"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2007.02272.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03502.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.11580"},{"issue":"8","key":"e_1_2_11_10_1","first-page":"11881","article-title":"Clinical efficacy of dexmedetomidine versus propofol in children undergoing magnetic resonance imaging: a meta\u2010analysis","volume":"8","author":"Fang H","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2015-0280"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2011.03.008"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000273"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-013-1657-x"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13202"},{"issue":"3","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1097\/PEC.0000000000001199","article-title":"The use of intranasal dexmedetomidine and midazolam for sedated magnetic resonance imaging in children: A report from the pediatric sedation research consortium","volume":"36","author":"Sulton C","year":"2020","journal-title":"Pediatr Emerg Care"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001246"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2004.01243.x"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12857"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13400"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2010.04.010"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002809"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000001350"},{"key":"e_1_2_11_24_1","unstructured":"US Food and Drug Administration.FDA drug safety communication: FDA approves label changes for use of general anesthetic and sedation drugs in young children.2017.https:\/\/www.fda.gov\/downloads\/Drugs\/DrugSafety\/UCM554644.pdf. Accessed March 12 2021."},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ntt.2017.01.001"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13904"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14225","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pan.14225","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14225","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T00:44:28Z","timestamp":1699058668000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.14225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,22]]},"references-count":25,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1111\/pan.14225"],"URL":"https:\/\/doi.org\/10.1111\/pan.14225","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,22]]},"assertion":[{"value":"2021-03-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}