Purpose or Case Report: The use of feed and swaddle (FS) technique in infants has increased in popularity due to the concern for neurotoxicity from medications used for anesthesia or sedation. The purpose for evaluating the age group < 6 months of age was to understand current imaging sedation and anesthesia practice patterns based on a survey of member institutions of the Society of Chairs of Radiology at Children’s Hospitals (SCORCH) in conjunction with the American College of Radiology’s Pediatric Imaging Sedation and Anesthesia Committee.
Methods & Materials: A survey composed of 27 questions pertaining to the use of imaging sedation and anesthesia in pediatric radiology departments was distributed to SCORCH institutions in January 2019 via SurveyMonkey(San Mateo, CA). Three questions (12,15 and 18) required recording the percentage of motion reduction techniques used over the past year in infants <6 months for specific exams - Chest CT with contrast enhancement(CTCE), Brain MRI with contrast enhancement(BMCE), and liver mass MRI with contrast enhancement(LMCE). The technique options included no sedation(NS), feed and swaddle(FS), sedation(S), and general anesthesia(GA). Numbers had to add up to 100. S and GA were combined in the analysis. Descriptive statistical analyses were performed.
Results:
Question 12 focused on CTCE had 19 respondents. A majority of sites 17/19(90%) offered NS and/or FS. 14/19(74%) used NS as a technique with 4 sites using NS in 90-100% of cases. 8/19(42%) used FS. 1 site used FS for all cases and 1 site used NS for all cases. Most sites,15/19(79%), offered S or GA. 2 sites used GA for all cases, 1 site used S/GA in 80% and the remainder used S/GA in 50% or fewer cases. Question 15 focused on BMCE had 19 respondents. A majority of sites, 80%, offered FS with variable use: 3/19(16%) in >80%, 4/19( 21%) in 30 to 50% and 8/19(42%) in 5-20%. 1/3 of sites used NS in 2-30% of cases. A majority of sites 12/19(63%) used S/GA in 80% -100% of cases. 1 site used FS for all cases. Question 18 focused on LMCE had 18 respondents. 5/18 (28%) of sites used FS or NS. Most sites, 13/18(72%) used S/GA only in 100% of cases.
Conclusions: The data shows variability in the use of motion reduction techniques and differences in use among sites. Results for FS and NS are promising with room for improvement with sharing of protocols. MRI studies had high use of S and GA, but there were sites performing exams without sedation. The experiences of those programs and collaboration may help decrease the use of sedation and GA.