Perfil de utilização de sedação para realização de ressonância magnética em um centro oncológico

Abstract

The use of sedation in magnetic resonance imaging (MRI) exams is a problem because more serious complications such as respiratory, neurological and cardiovascular. Furthermore, in addition to the risks that the patient is subjected to, special logistics are necessary - assistance by an anesthesiologist throughout the examination period, need for fasting, appropriate equipment, non-invasive monitoring during the examination and pre-anesthetic evaluation in elderly or comorbidities. Our objective was to study the profile of use of sedation in MRI in an oncology center. The population of the prospective cross-sectional study consisted of 227 patients who had an indication for sedation to undergo an MRI examination for reasons such as phobia, pain, children, difficulty in standing still and dementia or schizophrenia. We classified the study population according to the age group, with 83 (36.6%) pediatric children who required sedation by age and 144 (63.4%) adult patients according to the indication for sedation. We observed in this study a high number of tests indicated for the phobia motive 114/144 (79.2%) of adult patients, phobia was the most common cause in males 43 (72.9%) and females 71 (83.5 %) without statistical difference. Pain was the second most common cause among men 18 (30.5%) and women 10 (11.8%), was more frequent in men with a significant difference. Phobia was the most frequent indication in outpatients in 99 (86.8%) with a significant difference and for the pain reason there was a significant difference, being more common in patients with worse clinical conditions who were hospitalized with 14 (46.7%). According to baseline health by ASA, patients with phobia were more often in Asa I/II (86.3%) than in ASA III/IV (65.3%). Phobia was a more common cause of sedation in non-cancer patients in 34 (91.9%) than in cancer patients 80 (74.8%), while in pain although there was no statistical significance, there was a tendency to be more frequent in cancer patients with 25 (23.4%), a borderline significance. In our population 1/3 of the patients were sedated with risk classification with ASA III / IV, who have several comorbidities and in some cases are life-threatening. The most indicated reason for sedation for adult patients was phobia 114 (79.2%) followed by pain 28 (19,4%). The indication of the exam for the reason phobia and pain was mostly performed on an outpatient basis p <0.05. At-risk patients evaluated in ASA III / IV underwent an MR examination with sedation, mostly due to phobia.