Magnetic resonance imaging under sedation in newborns and infants: a study of 640 cases using sevoflurane

Background: The purpose of the present study was to show that sevoflurane is a safe and effective agent for the sedation of newborns and infants who are to undergo magnetic resonance imaging (MRI) examinations. Methods: The study was performed on 640 infants aged from 1 day to 12 months given sevoflurane in high concentrations - up to 7% at the 2 min induction peak. Following induction and during MRI examination, the children were maintained with spontaneous respiration and sedation levels with a sevoflurane concentration of approximately 1.5-2%, in combination with a mixture of oxygen and nitrous oxide (50% O-2-50% N2O). Results: Sedation proved optimal in 97.9% of cases and complications were one case of vomiting, eight cases of minor hypoxia and two of severe hypoxia. No case of prolonged sedation or postoperative emergence agitation was observed. Conclusions: Sevoflurane is an ideal agent for this type of diagnostic procedure in newborns and infants. We discuss the need for elaborating specific protocols for pediatric sedation and emphasize the strict observation of recommendations, which include the practical experience and up-to-date specialized training of the anesthesiologist carrying out sedation procedures in children.