• Gianpaolo Serafini and Nicola Zadra.
• Anaesthesia and Intensive Care Unit 1, IRCCS Foundation, S.Matteo, Pavia University, Pavia, Italy. gp.serafini@yahoo.it
• Curr Opin Anaesthesiol. 2008 Aug 1;21(4):499-503.

Purpose Of ReviewThe purpose of the present review is to focus on the literature in the past year and specifically the development of recent guidelines, the debate on who does the sedation anaesthesia for MRI in a paediatric patient, the use of medications and techniques, and the use of monitors and equipment.Recent FindingsThe revised guidelines of American Academy of Pediatrics and American Academy of Pediatric Dentistry underline the serious risks associated with the sedation of paediatric patients and emphasize the need for proper preparation and proper evaluation. Most children require deep sedation for MRI and the practitioner must have appropriate skills to rescue the patient from general anaesthesia. In the debate on 'who does the sedation', the most important goal is to achieve uniformity in the formal training of the practitioners in key practice elements (airway management, resuscitation, vascular access, medications). Recent findings about the use of anaesthetic techniques, monitors and equipment, and complications are reported.SummaryThe MRI suite is a challenging environment for anaesthetists and nonanaesthetists, and has serious risks. A systematic approach, similar to that of anaesthesia provided in the operating room, is mandatory. A well equipped anaesthesia machine, standard monitoring, trained personnel and adequate planning should be standard for all procedures out of the operating room.

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