Original ArticleThe Effects of Anesthesia on the Pediatric Developing Brain: Strategies to Reduce Anesthesia Use in Pediatric MRI and Nursing's Role in Driving Patient Safety
Section snippets
Identification of Studies and Study Selection
A search of the scientific literature was conducted using research databases such as CINAHL, Academic Search Premier, PubMed, PsychINFO, AMED, the Cochrane Library, Ovid, and MEDLINE to ensure that all the literature pertaining to the fields of pediatric sedation and physiological implications and child life was included in the review. All reviews included the peer-reviewed literature from January 2005 through June 2015, and abstracts were reviewed to determine eligibility for inclusion.
Risks and Side Effects of Anesthetic Agents Used for Children in MRI
The literature presented the efficacy, risks, and side effects associated with the pharmacologic agents used to sedate or anesthetize children needing an MRI. Common drugs used for MRI sedation include chloral hydrate, dexmedetomidine, midazolam-pentobarbital-fentanyl combination, isoflurane, sevoflurane, nitrous oxide, and propofol.9, 10, 11, 12, 13, 14 Incident of side effects from the drugs used for sedation or anesthesia in children for MRI range in occurrence. Potential side effects
Conclusions
The primary rationale for the use of sedation or GA in MRI is to ensure that the child remains still for the duration of time while the scan is being conducted. However, the use of sedation or GA is not benign and has real physiological and biological side effects for children. The safety risks and side effects of anesthetic agents used for children requiring an MRI include ED, respiratory depression, oxygenation, nausea, vomiting, agitation, and cardiovascular bradycardia. Of growing concern
Kari A. Mastro, PhD, RN, NEA-BC, Center for Health Services Research and Policy, Rutgers School of Nursing, Newark, NJ, and St. Mary Medical Center, Langhorne, PA
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Kari A. Mastro, PhD, RN, NEA-BC, Center for Health Services Research and Policy, Rutgers School of Nursing, Newark, NJ, and St. Mary Medical Center, Langhorne, PA
Linda Flynn, PhD, RN, FAAN, Center for Health Services Research and Policy, Rutgers School of Nursing, Rutgers The State University of New Jersey, Newark, NJ
Christa Preuster, MSN, RN, PMHCNS-BC, Rutgers School of Nursing, Rutgers The State University of New Jersey, Newark, NJ, and Columbia University, School of Nursing, New York City, NY
Lisa Summers-Gibson, MSN-ED, RN, CDE, NEA-BC, St. Mary Medical Center, Langhorne, PA
Mark H. Stein, MD, Department of Anesthesiology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
Conflict of Interest: None to report.