Child life intervention successfully decreases anaesthesia requirements in young children undergoing outpatient orthopaedic magnetic resonance imaging (MRI): a retrospective cohort study.

Overview

abstract

AIM: Magnetic resonance imaging (MRI) is the preferred imaging modality for soft-tissue and nonossified bone in paediatric orthopaedics; however, the confines, noise, and prolonged duration may prove challenging. Sedation can mitigate these issues but introduces potential risks of allergic reactions and impact on neurocognitive development. Studies have demonstrated reduced anxiety following Certified Child Life Specialists (CCLSs) intervention during paediatric MRIs. This study presents one institution's experience with CCLS intervention in children undergoing MRIs. MATERIALS AND METHODS: This single-centre retrospective study reviewed patients from 2016-2024 children aged 4-12 who underwent outpatient orthopaedic MRI were included. CCLS intervention, diagnosis associated with MRI, MRI region, and use of sedation were recorded. Patients were stratified into the pre-CCLS cohort and post-CCLS cohort, based on the presence of CCLS at the institution. Descriptive statistics analysed frequency of sedation. RESULTS: 1931 patients (2300 scans) were included, with a mean age of 10.0 ± 2.1 years: 708 patients (817 scans) in the pre-CCLS intervention cohort and 1224 patients (1483 scans) in the post-CCLS intervention cohort (one patient was in both groups). Overall, 7/1931 (0.4%) of patients, (7/2300 scans, 0.3%) required IV sedation. 108/1224 patients (116/1483 scans) in the post-CCLS cohort received CCLS intervention; of these, 0/108 patients (0/116 scans) required IV sedation. Mean age was significantly lower in patients receiving CCLS intervention versus no intervention (7.0 ± 2.1 vs 10.0 ± 2.0 years, P < 0.001). CONCLUSION: overall sedation rate for children undergoing MRI with CCLS was 0%. Our positive experience supports CCLS as a potential therapeutic intervention for younger children to undergo MRI.