Non-sedation of the neonate for radiologic procedures
1Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 75 Francis St., Rm. CWN418, Boston, MA, 02115, USA. rparad@bwh.harvard.edu.
Insights
The U.S. Food and Drug Administration (FDA) warns about anesthesia risks to developing brains in children under 3 and pregnant women. This review focuses on neonates, recommending avoiding sedation during newborn procedural imaging.
Area of Science:
- Pediatric Radiology
- Neurodevelopmental Toxicology
Background:
- FDA issued a warning on December 16, 2016, concerning the neurotoxicity of anesthesia and sedation agents.
- Developing brains in children under 3 years and fetuses in the 3rd trimester are particularly vulnerable.
- Concerns impact pediatric radiologists' considerations for image quality in pediatric patients.
Purpose of the Study:
- To review the specific risks of anesthesia and sedation in the highest-risk group: preterm and term neonates.
- To provide guidance and rationale for avoiding sedation in procedural imaging of newborns.
- To inform pediatric radiologists about neurotoxicity concerns and best practices.
Main Methods:
- Literature review on anesthesia/sedation neurotoxicity.
- Analysis of FDA warnings and recommendations.
- Focus on neonatal neurodevelopmental risks.
- Guideline development for procedural imaging in newborns.
Main Results:
- Anesthesia and sedation agents pose potential neurotoxic risks to the developing brains of young children and fetuses.
- Neonates, especially preterm infants, represent a high-risk group requiring special consideration.
- Evidence supports the avoidance of sedation in procedural imaging for newborns whenever feasible.
Conclusions:
- Pediatric radiologists must consider the potential neurotoxicity of anesthetic agents in young children.
- Avoiding sedation in procedural imaging of neonates is recommended to protect developing brains.
- Further research and clinical guidelines are needed to optimize imaging practices for vulnerable pediatric populations.
Abstract:
On Dec. 16, 2016, the U.S. Food and Drug Administration (FDA) released a warning regarding the potential neurotoxicity of anesthesia and sedation agents on the developing brain in children younger than 3 years and in women during their 3rd trimester of pregnancy. These concerns have relevance to the pediatric radiologist who must take into consideration how the child's state might impact image quality. In this review the author provides background on the special concerns in the potentially highest-risk group, pre-term and term neonates, and provides guidance and rationale for the avoidance of sedation in procedural imaging of the newborn.
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