TY - JOUR
T1 - Melatonin in neuropaediatric MRI
T2 - a retrospective study of efficacy in a general hospital setting
AU - Heida, Elebarta J. E.
AU - Lunsing, Roelineke J.
AU - Brouwer, Oebele F.
AU - Meiners, Linda C.
PY - 2020/3
Y1 - 2020/3
N2 - Background: Melatonin may offer a safe and cheap alternative to general anaesthesia and sedatives in neuropaediatric MRI. The purpose of our study was to evaluate its efficacy during a daily scanning programme and to assess its financial benefit. Methods: Neuro-MRI scans, performed in a general hospital setting after administration of melatonin in 64 children aged 10 months–5 years, were retrospectively reassessed by an experienced paediatric neuroradiologist, rating them as diagnostically contributing or as failed. The financial benefit was calculated. Results: 49/64 scans (77%) were diagnostically contributing, in 11 (22%) no movement artefact was seen in any sequence; 15/64 scans failed (23%), in 3/15 because of serious movement artefacts, in 12/15 the scan was not started. Repeat scans under general anaesthesia were performed in 17 cases (27%): in the 15 failed cases and in 2 cases initially assessed as failed, but were considered diagnostically contributing in the present study. The financial benefit at the time the scans were made was approximately 13,360 Euro. Conclusions: In this retrospective study, the use of melatonin in neuropaediatric MRI, made during a daily scanning programme with a remote waiting room, was associated with a high success rate in infants and young children. A minority of scans had no movement artefacts, indicating most children were not asleep. The sleep-inducing effect of melatonin could therefore not be proven, but the high success rate may be attributed to the sedative and/or anxiolytic effect of melatonin. Only a minority of scans had to be repeated under general anesthesia, leading to a reduction of scan related costs.
AB - Background: Melatonin may offer a safe and cheap alternative to general anaesthesia and sedatives in neuropaediatric MRI. The purpose of our study was to evaluate its efficacy during a daily scanning programme and to assess its financial benefit. Methods: Neuro-MRI scans, performed in a general hospital setting after administration of melatonin in 64 children aged 10 months–5 years, were retrospectively reassessed by an experienced paediatric neuroradiologist, rating them as diagnostically contributing or as failed. The financial benefit was calculated. Results: 49/64 scans (77%) were diagnostically contributing, in 11 (22%) no movement artefact was seen in any sequence; 15/64 scans failed (23%), in 3/15 because of serious movement artefacts, in 12/15 the scan was not started. Repeat scans under general anaesthesia were performed in 17 cases (27%): in the 15 failed cases and in 2 cases initially assessed as failed, but were considered diagnostically contributing in the present study. The financial benefit at the time the scans were made was approximately 13,360 Euro. Conclusions: In this retrospective study, the use of melatonin in neuropaediatric MRI, made during a daily scanning programme with a remote waiting room, was associated with a high success rate in infants and young children. A minority of scans had no movement artefacts, indicating most children were not asleep. The sleep-inducing effect of melatonin could therefore not be proven, but the high success rate may be attributed to the sedative and/or anxiolytic effect of melatonin. Only a minority of scans had to be repeated under general anesthesia, leading to a reduction of scan related costs.
KW - Melatonin
KW - Efficacy
KW - Neuropaediatric
KW - MRI
KW - ELECTROENCEPHALOGRAM RECORDINGS
KW - SLEEP-DEPRIVATION
KW - CHILDREN
KW - SEDATION
KW - ANESTHESIA
KW - SYSTEM
KW - BLADE
U2 - 10.1016/j.ejpn.2019.10.001
DO - 10.1016/j.ejpn.2019.10.001
M3 - Article
SN - 1090-3798
VL - 25
SP - 172
EP - 180
JO - European Journal of Paediatric Neurology
JF - European Journal of Paediatric Neurology
ER -