{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T03:04:49Z","timestamp":1793934289149,"version":"4.8.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T00:00:00Z","timestamp":1576627200000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Children require anesthesia for MRI to maintain immobility and reduce discomfort; clear indications about the best anesthesiologic management are lacking and each center developed its own protocol. Moreover, children with neuropsychiatric disorders more likely require sedation and are described in literature as more prone to general and respiratory complications. Aim of this study was to analyze the applicability of a sevoflurane-based approach, to describe general and respiratory complications and to identify risk factors in a pediatric neuropsychiatric population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study, university Hospital (January 2007\u2013December 2016). All the 1469 anesthesiologic records of children addressed from Neuropsychiatric Unit to undergo MRI under general anesthesia were analyzed; 12 patients equal or older than 18-year-old were excluded. We identified post-hoc nine macro-categories: static encephalopathies, metabolic\/evolutive encephalopathies, epileptic encephalopathies, neuromuscular diseases, autistic spectrum disorders, migraine, psychiatric disorders, intellectual disabilities, others. A logistic regression model for events with low frequency (Firth\u2019s penalized likelihood approach) was carried out to identify the mutually adjusted effect among endpoints (complications) and the independent variables chosen on the basis of statistical significance (univariate analysis,<jats:italic>p<\/jats:italic>\u00a0\u2264\u20090.05) and clinical judgment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1457 anesthesiologic records (age 4.0 (IQR 2.0 to 7.0) year-old, males 891 (61.2%), weight 17.0 (IQR 12.0 to 24.9) kg), 18 were cancelled for high anesthesiologic risk, 50 were cooperative, 1389 were anesthetized. A sevoflurane-based anesthesia was feasible in 92.3%; these patients required significantly less mechanical ventilation (8.6 vs. 16.2%;<jats:italic>p<\/jats:italic>\u00a0=\u20090.012). Complications\u2019 rate was low (6.2%; 3.1% respiratory). The risk for general complications increases with ASA score\u2009&gt;\u20091 (OR 2.22, 95 CI% 1.30 to 3.77,<jats:italic>p<\/jats:italic>\u00a0=\u20090.003), male sex (OR 1.73, 95% CI 1.07 to 2.81,<jats:italic>p<\/jats:italic>\u00a0=\u20090.025), multi-drug anesthesia (OR 2.98, 95 CI% 1.26 to 7.06,<jats:italic>p<\/jats:italic>\u00a0=\u20090.013). For respiratory complications, it increases with ASA score\u2009&gt;\u20091 (OR 2.34, 95 CI% 1.19 to 4.73,<jats:italic>p<\/jats:italic>\u00a0=\u20090.017), autumn-winter (OR 2.01, 95 CI% 1.06 to 3.78,<jats:italic>p<\/jats:italic>\u00a0=\u20090.030), neuromuscular disorders (OR 3.18, 95 CI% 1.20 to 8.41,<jats:italic>p<\/jats:italic>\u00a0=\u20090.020). We had no major complications compromising patients\u2019 outcome or requiring admission to ICU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sevoflurane anesthesia is feasible and safe for children affected by neuropsychiatric disorders undergoing MRI. Specific risk factors for general and respiratory complications should be considered.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12871-019-0897-1","type":"journal-article","created":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T16:02:52Z","timestamp":1576684972000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Ten-year experience with standardized non-operating room anesthesia with Sevoflurane for MRI in children affected by neuropsychiatric disorders"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1987-8599","authenticated-orcid":false,"given":"Silvia","family":"Mongodi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Ottonello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaelealdo","family":"Viggiano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Borrelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Orcesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Pichiecchio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Balottin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Mojoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio Antonio","family":"Iotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,18]]},"reference":[{"key":"897_CR1","doi-asserted-by":"publisher","first-page":"i97","DOI":"10.1093\/bja\/aew210","volume":"117","author":"FE Ucisik-Keser","year":"2016","unstructured":"Ucisik-Keser FE, Chi TL, Hamid Y, Dinh A, Chang E, Ferson DZ. Impact of airway management strategies on magnetic resonance image quality. Br J Anaesth. 2016;117:i97\u2013i102.","journal-title":"Br J Anaesth"},{"key":"897_CR2","doi-asserted-by":"crossref","unstructured":"Guidelines for the elective use of conscious sedation, deep sedation, and general anaesthesia in paediatric patients. Committee on drugs. Section on anesthesiology. Paediatrics. 1985;76:317\u201321. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Guidelines+for+the+elective+use+of+conscious+sedation%2C+deep+sedation%2C+and+general+anaesthesia+in+paediatric+patients.+Committee+on+drugs.+Section+on+anesthesiology.+Paediatrics.","DOI":"10.1542\/peds.76.2.317"},{"issue":"6","key":"897_CR3","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1111\/pan.13615","volume":"29","author":"M Zielinska","year":"2019","unstructured":"Zielinska M, Bartkowska-Sniatkowska A, Becke K, et al. Safe pediatric procedural sedation and analgesia by anesthesiologists for elective procedures: a clinical practice statement from the European Society for Paediatric Anaesthesiology. Paediatr Anaesth. 2019;29(6):583\u201390.","journal-title":"Paediatr Anaesth"},{"key":"897_CR4","doi-asserted-by":"crossref","unstructured":"Cot\u00e9 CJ, Wilson S. American academy of paediatrics, American academy of paediatric dentistry. Guidelines for monitoring and management of paediatric patients before, during, and after sedation for diagnostic and therapeutic procedures: update 2016. Paediatrics. 2016;138(1).","DOI":"10.1542\/peds.2016-1212"},{"key":"897_CR5","first-page":"675","volume":"70","author":"A Levati","year":"2004","unstructured":"Levati A, Paccagnella F, Pietrini D, et al. SIAARTI-SARNePI guidelines for sedation in paediatric neuroradiology. Minerva Anestesiol. 2004;70:675.","journal-title":"Minerva Anestesiol"},{"key":"897_CR6","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1213\/00000539-199712000-00005","volume":"85","author":"S Malviya","year":"1997","unstructured":"Malviya S, Voepel-Lewis T, Tait AR. Adverse events and risk factors associated with sedation of children by nonanesthesiologists. Anesth Analg. 1997;85:1207\u201313.","journal-title":"Anesth Analg"},{"key":"897_CR7","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1093\/oxfordjournals.bja.a013586","volume":"84","author":"S Malviya","year":"2000","unstructured":"Malviya S, Voepel-Lewis T, Eldevik OP, Rockwell DT, Wong JH, Tait AR. Sedation and general anaesthesia in children undergoing MRI and CT: adverse events and outcomes. Br J Anaesth. 2000;84:743\u20138.","journal-title":"Br J Anaesth"},{"key":"897_CR8","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1111\/j.1460-9592.2006.02178.x","volume":"17","author":"P Cortellazzi","year":"2007","unstructured":"Cortellazzi P, Lamperti M, Minati L, Falcone C, Pantaleoni C, Caldiroli D. Sedation for neurologically impaired children undergoing MRI: a sequential approach. Paediatr Anaesth. 2007;17:630\u20136.","journal-title":"Paediatr Anaesth"},{"key":"897_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/PEC.0000000000000059","volume":"30","author":"JD Hoyle","year":"2014","unstructured":"Hoyle JD, Callahan JM, Badaway M, et al. Traumatic brain injury study group for the paediatric emergency care applied research network (PECARN). Pediatr Emerg Care. 2014;30:1\u20137.","journal-title":"Pediatr Emerg Care"},{"key":"897_CR10","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1111\/j.1460-9592.2007.02272.x","volume":"17","author":"CM Heard","year":"2007","unstructured":"Heard CM, Joshi P, Johnson K. Dexmedetomidine for paediatric MRI sedation: a review of a series of cases. Paediatr Anaesth. 2007;17:888\u201392.","journal-title":"Paediatr Anaesth"},{"key":"897_CR11","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.pediatrneurol.2009.02.006","volume":"41","author":"N Lubisch","year":"2009","unstructured":"Lubisch N, Roskos R, Berkenbosch JW. Dexmedetomidine for procedural sedation in children with autism and other behavior disorders. Paediatr Neurol. 2009;41:88\u201394.","journal-title":"Paediatr Neurol"},{"key":"897_CR12","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1111\/j.1460-9592.2004.01390.x","volume":"15","author":"AG Usher","year":"2005","unstructured":"Usher AG, Kearney RA, Tsui BC. Propofol total intravenous anaesthesia for MRI in children. Paediatr Anaesth. 2005;15:23\u20138.","journal-title":"Paediatr Anaesth"},{"key":"897_CR13","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1213\/ane.0b013e31818fc334","volume":"108","author":"JP Cravero","year":"2009","unstructured":"Cravero JP, Beach ML, Blike GT, Gallagher SM, Hertzog JH. Paediatric sedation research consortium. The incidence and nature of adverse events during paediatric sedation \/ anaesthesia with propofol for procedures outside the operating room: a report from the paediatric sedation research consortium. Anesth Analg. 2009;108:795\u2013804.","journal-title":"Anesth Analg."},{"key":"897_CR14","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1007\/s00247-013-2701-6","volume":"43","author":"MA Griffiths","year":"2013","unstructured":"Griffiths MA, Kamat PP, McCracken CE, Simon HK. Is procedural sedation with propofol acceptable for complex imaging? A comparison of short vs. prolonged sedations in children. Pediatr Radiol. 2013;43:1273\u20138.","journal-title":"Pediatr Radiol"},{"issue":"2","key":"897_CR15","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1093\/bja\/aen153","volume":"101","author":"AM Machata","year":"2008","unstructured":"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\u201343.","journal-title":"Br J Anaesth"},{"issue":"1","key":"897_CR16","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1111\/j.1460-9592.2005.01456.x","volume":"15","author":"MR Sury","year":"2005","unstructured":"Sury MR, Harker H, Thomas ML. Sevoflurane sedation in infants undergoing MRI: a preliminary report. Paediatr Anaesth. 2005;15(1):16\u201322.","journal-title":"Paediatr Anaesth"},{"key":"897_CR17","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1111\/j.1460-9592.2005.01360.x","volume":"15","author":"V De Sanctis Briggs","year":"2005","unstructured":"De Sanctis Briggs V. Magnetic resonance imaging under sedation in newborns and infants: a study of 640 cases using sevoflurane. Paediatr Anaesth. 2005;15:9\u201315.","journal-title":"Paediatr Anaesth"},{"key":"897_CR18","doi-asserted-by":"crossref","unstructured":"Todd JK, Friess SH, Raghupathi R, Huh JW. Sedation and analgesia in children with developmental disabilities and neurologic disorders. Int J Pediatr. 2010;2010.","DOI":"10.1155\/2010\/189142"},{"key":"897_CR19","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1111\/j.1460-9592.2008.02900.x","volume":"19","author":"N Kannikeswaran","year":"2009","unstructured":"Kannikeswaran N, Mahajan PV, Sethuraman U, Groebe A, Chen X. Sedation medication received and adverse events related to sedation for brain MRI in children with and without developmental disabilities. Paediatr Anaesth. 2009;19:250\u20136.","journal-title":"Paediatr Anaesth"},{"key":"897_CR20","doi-asserted-by":"publisher","first-page":"4482","DOI":"10.1016\/S0952-8180(01)00312-9","volume":"13","author":"T Elwood","year":"2001","unstructured":"Elwood T, Hansen LD, Seely JM. Oropharyngeal airway diameter during sedation in children with and without developmental delay. J Clin Anesth. 2001;13:4482\u20135.","journal-title":"J Clin Anesth"},{"issue":"4","key":"897_CR21","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1097\/00000539-200010000-00014","volume":"91","author":"MG Butler","year":"2000","unstructured":"Butler MG, Hayes BG, Hathaway MM, Begleiter ML. Specific genetic diseases at risk for sedation\/anesthesia complications. Anesth Analg. 2000 Oct;91(4):837\u201355.","journal-title":"Anesth Analg"},{"key":"897_CR22","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1111\/j.1365-2044.1997.257-az0376.x","volume":"52","author":"FJ Frei","year":"1997","unstructured":"Frei FJ, Haemmerle MH, Brunner R, Kern C. Minimum alveolar concentration for halothane in children with cerebral palsy and severe mental retardation. Anaesth. 1997;52:1056\u201360.","journal-title":"Anaesth"},{"key":"897_CR23","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/j.atc.2005.08.001","volume":"23","author":"MC Theroux","year":"2005","unstructured":"Theroux MC, Akins RE. Surgery and anesthesia for children who have cerebral palsy. Anesth Clin North Am. 2005;23:733\u201343.","journal-title":"Anesth Clin North Am"},{"issue":"Suppl 1","key":"897_CR24","doi-asserted-by":"publisher","first-page":"i79","DOI":"10.1093\/bja\/aer335","volume":"107","author":"J Lerman","year":"2011","unstructured":"Lerman J. Perioperative management of the paediatric patient with coexisting neuromuscular disease. Br J Anaesth. 2011 Dec;107(Suppl 1):i79\u201389.","journal-title":"Br J Anaesth"},{"key":"897_CR25","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1002\/mus.23817","volume":"48","author":"A Romero","year":"2013","unstructured":"Romero A, Joshi GP. Neuromuscular disease and anesthesia. Muscle Nerve. 2013;48:451\u201360.","journal-title":"Muscle Nerve"},{"issue":"9","key":"897_CR26","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1111\/pan.12214","volume":"23","author":"JA Blatter","year":"2013","unstructured":"Blatter JA, Finder JD. Perioperative respiratory management of pediatric patients with neuromuscular disease. Paediatr Anaesth. 2013 Sep;23(9):770\u20136.","journal-title":"Paediatr Anaesth"},{"issue":"22","key":"897_CR27","first-page":"3347","volume":"18","author":"AB Ozer","year":"2014","unstructured":"Ozer AB, Demirel I, Gokdemir T, Erhan OL. Anaesthesia management in a child with metabolic myopathy. Eur Rev Med Pharmacol Sci. 2014 Nov;18(22):3347\u20138.","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"897_CR28","doi-asserted-by":"crossref","unstructured":"Kynes JM, Blakely M, Furman K, Burnette WB, Modes KB. Multidisciplinary Perioperative Care for Children with Neuromuscular Disorders. Children (Basel). 2018 Sep 12;5(9). pii: E126.","DOI":"10.3390\/children5090126"},{"issue":"9","key":"897_CR29","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1111\/pan.12248","volume":"23","author":"LG Segura","year":"2013","unstructured":"Segura LG, Lorenz JD, Weingarten TN, Scavonetto F, Bojani\u0107 K, Selcen D, Sprung J. Anesthesia and Duchenne or Becker muscular dystrophy: review of 117 anesthetic exposures. Paediatr Anaesth. 2013 Sep;23(9):855\u201364.","journal-title":"Paediatr Anaesth"},{"issue":"9","key":"897_CR30","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1111\/pan.12159","volume":"23","author":"G Islander","year":"2013","unstructured":"Islander G. Anesthesia and spinal muscle atrophy. Paediatr Anaesth. 2013 Sep;23(9):804\u201316.","journal-title":"Paediatr Anaesth"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-019-0897-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12871-019-0897-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-019-0897-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T20:40:14Z","timestamp":1665261614000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-019-0897-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["897"],"URL":"https:\/\/doi.org\/10.1186\/s12871-019-0897-1","relation":{},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12]]},"assertion":[{"value":"5 July 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 November 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 December 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Research was performed in accordance with the Declaration of Helsinki. Ethical approval for this study (Ethical Committee N\u00b0 P-20170030606) was provided by the Ethical Committee NAC of Fondazione IRCCS Policlinico S. Matteo University Hospitals, Pavia, Italy (Chairperson Prof M. Cazzola) on December 5th, 2017; the need for written consent was waived by the ethics committee.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"235"}}