小児の鎮静MRI検査にまつわる諸問題と今後の方向性

Sedation for Magnetic Resonance Imaging in Pediatric Patients: Complications and Future Measures

Point

・鎮静処置には呼吸不全や心停止の危険があり，「リスクのない鎮静はない」と認識しなければならない．

・「MRI検査時の鎮静に関する共同提言」はあるべき姿を示している．熟知しよう．

・鎮静MRI検査を安全に実施するとともに，薬に頼らない鎮静（無鎮静）で検査できるように努める．

　The use of sedation to examine children is common in hospitals. MRI examinations require sedation when applied to pediatric patients, because of the high magnetic field and noisy environment, but complications such as respiratory failure and cardiac arrest have occurred in Japan. Unfortunately, there is no risk-free sedation. In order to perform sedation safely, it is necessary to understand the Recommendation on pediatric sedation for MRI examinations, which was published in 2020. Restrictions on oral intake prior to the exam and the 2-4-6 rules must be adhered to in order to avoid vomiting, and patients must be monitored every 5 minutes during the exam. In addition, non-sedative MRI with the use of videos and preparation tools should be performed more often.