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J Am Coll Radiol. 2018 Sep;15(9):1232-1237. doi: 10.1016/j.jacr.2017.12.022. Epub 2018 Mar 2.

The Utility of the Modified Yale Preoperative Anxiety Scale for Predicting Success in Pediatric Patients Undergoing MRI Without the Use of Anesthesia.

Author information

1
Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio; Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, Ohio. Electronic address: Arlyne.Thung@Nationwidechildrens.org.
2
Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio.
3
Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio; Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, Ohio.
4
Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio; Department of Child Life, Nationwide Children's Hospital, Columbus, Ohio.
5
Department of Anesthesiology, Frank Netter School of Medicine, Hamden, Connecticut.

Abstract

PURPOSE:

MRI is a common modality for diagnostic imaging. In children, general anesthesia is often required to complete MRI examinations. Simulation training can reduce the need for anesthesia in some children. Reliable screening tools to select who could benefit from practice MRI sessions are lacking. This study evaluates the use of the modified Yale Preoperative Anxiety Scale (mYPAS) in effectively identifying patients who may benefit from simulation-based training.

METHODS:

Children aged 5 and older who were originally scheduled for MRI with anesthesia in 2015 to 2016 were prospectively recruited for simulation-based training. The mYPAS assessment was performed by trained certified child life specialists before and after practice MRI sessions. The primary outcome was whether mYPAS could predict completing an MRI examination without anesthesia.

RESULTS:

Eighty patients (43 boys and 37 girls, age 8.5 ± 3.0 years) were enrolled in the study. Eleven subjects (14%) required general anesthesia to complete the MRI examination despite participating in the simulation. In the overall cohort, mYPAS scores improved after simulation from 31 ± 11 to 27 ± 9 (95% confidence interval of difference, -6, -2; P < .001 by paired t test). Receiver operating characteristic curve analysis found that presimulation mYPAS had good utility for predicting anesthesia requirement for MRI completion (area under the curve = 0.81). A presimulation mYPAS score > 33 predicted need for anesthesia with 82% sensitivity and 78% specificity.

CONCLUSIONS:

The mYPAS is a quick screening tool to identify pediatric patients who could benefit from simulation training by being able to complete an MRI examination without anesthesia.

KEYWORDS:

MRI; mYPAS; simulation

PMID:
29483054
DOI:
10.1016/j.jacr.2017.12.022
[Indexed for MEDLINE]

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