Needle-free pharmacological sedation techniques in paediatric patients for imaging procedures: a systematic review and meta-analysis

Jasper Wylleman, Ingeborg de Rover, Jaap J. Dogger, Wichor M. Bramer, Sanne E. Hoeks, Jurgen C. de Graaff

Onderzoeksoutput: Articlepeer review

3 Citaten (Scopus)


Background: Sedation techniques and drugs are increasingly used in children undergoing imaging procedures. In this systematic review and meta-analysis, we present an overview of literature concerning sedation of children aged 0–8 yr for magnetic resonance imaging (MRI) procedures using needle-free pharmacological techniques. Methods: Embase, MEDLINE, Web of Science, and Cochrane databases were systematically searched for studies on the use of needle-free pharmacological sedation techniques for MRI procedures in children aged 0–8 yr. Studies using i.v. or i.m. medication or advanced airway devices were excluded. We performed a meta-analysis on sedation success rate. Secondary outcomes were onset time, duration, recovery, and adverse events. Results: Sixty-seven studies were included, with 22 380 participants. The pooled success rate for oral chloral hydrate was 94% (95% confidence interval [CI]: 0.91–0.96); for oral chloral hydrate and intranasal dexmedetomidine 95% (95% CI: 0.92–0.97); for rectal, oral, or intranasal midazolam 36% (95% CI: 0.14–0.65); for oral pentobarbital 99% (95% CI: 0.90–1.00); for rectal thiopental 92% (95% CI: 0.85–0.96); for oral melatonin 75% (95% CI: 0.54–0.89); for intranasal dexmedetomidine 62% (95% CI: 0.38–0.82); for intranasal dexmedetomidine and midazolam 94% (95% CI: 0.78–0.99); and for inhaled sevoflurane 98% (95% CI: 0.97–0.99). Conclusions: We found a large variation in medication, dosage, and route of administration for needle-free sedation. Success rates for sedation techniques varied between 36% and 98%.

Originele taal-2English
Pagina's (van-tot)51-73
Aantal pagina's23
TijdschriftBritish Journal of Anaesthesia
Nummer van het tijdschrift1
StatusPublished - jan 2022

Bibliografische nota

Publisher Copyright:
© 2022 The Author(s)

Copyright 2023 Elsevier B.V., All rights reserved.


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