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| |  RSNA: Melatonin Helps Children Sleep Through Magnetic Resonance Studies By Ed Susman Special to DG News CHICAGO, IL -- November 26, 2001 -- A 10 mg dose of melatonin given to unruly children prior to magnetic resonance imaging studies can make them fall asleep and allow the radiologist to complete the examination without need for anesthesia. Researchers at the 87th scientific assembly and annual meeting of the Radiological Society of North America yesterday said the use of melatonin-often suggested as an over-the-counter treatment for jet lag-would be applicable in smaller clinics and hospitals where magnetic resonance imaging (MRI) scans are performed routinely, but are not large enough to have adequate anesthesiologists or support staff available. Doctors at Birmingham Children’s Hospital, in Birmingham, England, recruited 50 children for the hospital-supported study. They were randomized into two groups: 25 patients were given melatonin in a drink; a second group of 25 “sleep-deprived” patients were also brought in to the hospital and given the melatonin cocktail. Overall 68 percent of the children went to sleep; 72 percent of the sleep-deprived children went to sleep. "Usually with young children who are undergoing MRI we use sedation," said Dr. Karl Johnson, a consultant pediatric radiologist at the hospital. "But the sedation of children undergoing MRI examination carried a risk of decreased oxygen saturation and of the child drifting into a deeper level of unconsciousness." In addition, Dr. Johnson said that when general anesthesia is used in these patients, it requires greater hospital staff utilization, and such staff and supplies may not be readily available at private clinics or community and regional hospitals that routinely perform MRI studies on adults. The 50 patients in Dr. Johnson’s study included 11 children under the age of four years of age; 16 children with developmental delay; 14 children with behavioral disturbances; five children had involuntary movements; three were autistic; and one had trisomy. "None of the children who received melatonin required a hospital, oxygen saturation monitoring or close nursing supervision," Dr. Johnson said. When the examinations were completed, a gentle shake awoke the children. He reported no side effects among those getting melatonin. "Of course, we have heard of melatonin being used to help people sleep, although I’ve not heard of its use in this setting," said Dr. Donald Frush, associate professor of radiology at Duke University School of Medicine, in Durham, North Carolina. "It. seems like a reasonable application." However, Dr. Frush said that it was unlikely large facilities such as Duke University, which performs a number of pediatric MRI examinations, would use the melatonin method of getting the children to cooperate. Since facilities such as Duke have the staffing necessary to monitor children under general anesthesia, he said it was unlikely that larger facilities would risk a 30 percent failure rate to get the children to sleep. Dr. Johnson concurred, saying that his institution, which draws patients from a 100 m radius in England, would likely use general anesthesia in young or uncooperative children. But he said it might make sense for a small clinic in an outlying area to try the melatonin approach rather than refer the child and parents to a long trip for the procedure.
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