Nader Shaikh1, Alejandro Hoberman2, Ron Keren3, Anastasia Ivanova4, Harvey A Ziessman5, Gang Cui6, Tej K Mattoo7, Sonika Bhatnagar2, Milan D Nadkarni8, Marva Moxey-Mims9, William A Primack10. 1. University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, Division of General Academic Pediatrics, One Children's Hospital Drive, 4401 Penn Ave., Pittsburgh, PA, 15224, USA. nader.shaikh@chp.edu. 2. University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, Division of General Academic Pediatrics, One Children's Hospital Drive, 4401 Penn Ave., Pittsburgh, PA, 15224, USA. 3. Division of General Pediatrics, Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA, USA. 4. Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 5. Department of Radiology, Johns Hopkins University, Baltimore, MD, USA. 6. Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 7. Division of Nephrology and Hypertension, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA. 8. Pediatric Emergency Department, Wake Forest School of Medicine, Brenner Children's Hospital, Winston-Salem, NC, USA. 9. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA. 10. University of North Carolina Kidney Center, Chapel Hill, NC, USA.
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.
RCT Entities:
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.
Authors: Natascha S Sandy; Hiep T Nguyen; Sonja I Ziniel; Brian J Minnillo; Frank J Penna; Angela M Franceschi; Jeanne S Chow Journal: J Urol Date: 2010-12-18 Impact factor: 7.450
Authors: Caleb P Nelson; Jeanne S Chow; Ilina Rosoklija; Sonja Ziniel; Jonathan C Routh; Bartley G Cilento Journal: J Urol Date: 2012-08-19 Impact factor: 7.450
Authors: Ron Keren; Myra A Carpenter; Alejandro Hoberman; Nader Shaikh; Tej K Matoo; Russell W Chesney; Ranjiv Matthews; Arlene C Gerson; Saul P Greenfield; Barbara Fivush; Gordon A McLurie; H Gil Rushton; Douglas Canning; Caleb P Nelson; Lawrence Greenbaum; Timothy Bukowski; William Primack; Richard Sutherland; James Hosking; Dawn Stewart; Jack Elder; Marva Moxey-Mims; Leroy Nyberg Journal: Pediatrics Date: 2008-12 Impact factor: 7.124
Authors: David S Hains; Harris L Cohen; M Beth McCarville; Ellen E Ellison; Amy Huffman; Stacey Glass; Aslam H Qureshi; Keith R Pierce; Ashlyn L Cahill; Ashley Dixon; Noel Delos Santos Journal: Kidney Int Rep Date: 2017-01-26