(1322) Profile of Pediatric Patients Requiring Noninvasive Procedural Sedation in an Imaging Center

Introduction: In recent years, there has been a notable rise in the number of pediatric patients requiring sedation for diagnostic imaging procedures. It is critical to assess the sedation safety and efficacy to achieve the desired outcomes and guarantee the patient conscious recovery. In this study, we determined the prevalence, average age, and common diagnosis for non-invasive procedures without and with sedation.

Methods: We evaluated patients that required non-invasive procedures in the imaging center from June 1st, 2024, to June 30th, 2024. The inclusion criteria were pediatric patients (0-21 years old) submitted to a non-invasive procedure without or with sedation. Patients who required use of opioids were excluded. We evaluated the percentage of procedures conducted with (dexmedetomidine (Dex) alone or Dex combined with other sedatives) and without sedation. A Mann-Whitney test was used to compare sedation time and study time between two groups, with a p-value < 0.05 for statistical significance.

Results: A total of 176 patients received services during the study. The most common procedure among patients that did not require sedation (116) was the CT (51%). The most frequent imaging study among patients that required sedation (34%) was the MRI, 57 (95%), specifically, Brain MRI (65%). The average age was 36 ± 51 months, the most common diagnosis were seizures, congenital brain malformations and autism spectrum disorder. Dex (63%) was the most frequent sedative used, followed by Dex combined with ketamine or midazolam (28%). Patients treated with Dex or Dex combined did not have a difference in sedation time (median time: 44 vs 47 minutes, p = 0.6). There was no difference in total study time between patients that received Dex or Dex combined with other drugs. No adverse events were reported during the study period.

Conclusions: Optimizing pediatric sedation for imaging procedures involves age, diagnosis, imaging study type, duration of study and individual response to sedative. No significant difference was found between Dex alone or in combination. Data demonstrated that as expected younger patients and developmental or behavioral problems required the use of sedation. Individualized protocols, monitoring, and post-procedure care improve efficiency, outcomes and maintain patient safety.