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A term infant is noted to have frequent seizures during the first day of postnatal life. There are no specific risk factors for infection or hypoxic ischaemic encephalopathy from the maternal or perinatal history. A sepsis evaluation including lumbar puncture, initial metabolic investigations and a cranial ultrasound prove unsupportive of any specific aetiology for the seizures. A neurology consultation is performed and cerebral MRI of the brain is recommended for further diagnostic evaluation. Is there sufficient evidence that imaging without sedation would provide satisfactory image quality?
Structured clinical question
In a non-intubated infant under the age of 6 months undergoing MRI (patient), does non-sedation result in image results (outcome) comparable with any form of sedation (comparison)?
Search strategy and outcome
Search date: 16 October 2012
Secondary Sources: The Cochrane library. Nil relevant. Primary Sources: Pubmed and Scopus. Search strategy used below including text words (tw) or medical subject headings (mh). Scopus was also searched in order to access Embase. (infant OR infants[tw] OR newborn[tw] OR newborns[tw] OR neonate[tw] OR neonates[tw] OR neonatal[tw]) AND (sedation[tw] OR sedative[tw] OR sedatives[tw] OR unsedated*[tw] OR nonsedat*[tw] OR immobiliz*[tw] OR physical restraint OR anaesthesia and analgesia[mh] OR anaesthesia[tw] OR anaesthetics OR hypnotics and sedatives[mh] OR narcotics) AND (MRI OR mri[tw] OR “mr imaging”[tw]). Total number of hits in Pubmed: 716. Total number of hits in Scopus: 88. Of these articles, 13 were considered relevant.
The remaining 791 articles were excluded as they either administered IV or oral sedation to all infants, and/or …
Contributors MH obtained primary data collection and analysis and was also the primary author of the finished manuscript. JK developed the investigation and did preliminary data gathering. JK also performed much of the revision of manuscript as well.
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.