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Utility of Sedation for Young Children Undergoing Dimercaptosuccinic Acid Renal Scans

Overview
Journal Pediatr Radiol
Specialty Pediatrics
Date 2016 Jun 12
PMID 27287454
Citations 5
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Abstract

Background: No studies have examined whether use of sedation during a Tc-99 m dimercaptosuccinic acid (DMSA) renal scan reduces patient discomfort.

Objective: To compare discomfort level during a DMSA scan to the discomfort level during other frequently performed uroradiologic tests, and to determine whether use of sedation during a DMSA scan modifies the level of discomfort.

Materials And Methods: We examined the discomfort level in 798 children enrolled in the Randomized Intervention for children with Vesicoureteral Reflux (RIVUR) and Careful Urinary Tract Infection Evaluation (CUTIE) studies by asking parents to rate their child's discomfort level with each procedure on a scale from 0 to 10. We compared discomfort during the DMSA scan and the DMSA image quality between centers in which sedation was used >90% of the time (sedation centers), centers in which sedation was used <10% of the time (non-sedation centers), and centers in which sedation was used on a case-by-case basis (selective centers).

Results: Mean discomfort level was highest for voiding cystourethrogram (6.4), followed by DMSA (4.0), followed by ultrasound (2.4; P<0.0001). Mean discomfort level during the DMSA scan was significantly higher at non-sedation centers than at selective centers (P<0.001). No difference was apparent in discomfort level during the DMSA scan between sedation centers and selective centers (P=0.12), or between the sedation centers and non-sedation centers (P=0.80). There were no differences in the proportion with uninterpretable DMSA scans according to sedation use.

Conclusion: Selective use of sedation in children 12-36 months of age can reduce the discomfort level experienced during a DMSA scan.

Citing Articles

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Damm T, Mathews R Arch Nephrol Ren Stud. 2022; 2(1):1-5.

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Contrast-enhanced voiding ultrasonography to detect intrarenal reflux in children: comparison with 99mTc-DMSA renal scans.

Oh S, Ha J, Cho Y Ultrasonography. 2022; 41(3):502-510.

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Long-term antibiotics for preventing recurrent urinary tract infection in children.

Williams G, Craig J Cochrane Database Syst Rev. 2019; 4:CD001534.

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Interventions for primary vesicoureteric reflux.

Williams G, Hodson E, Craig J Cochrane Database Syst Rev. 2019; 2:CD001532.

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Elucidation of Renal Scars in Children With Vesicoureteral Reflux Using Contrast-Enhanced Ultrasound: A Pilot Study.

Hains D, Cohen H, McCarville M, Ellison E, Huffman A, Glass S Kidney Int Rep. 2017; 2(3):420-424.

PMID: 29142969 PMC: 5678645. DOI: 10.1016/j.ekir.2017.01.008.

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