For patients who may experience claustrophobia during an MRI scan and require prophylaxis, the University of Wisconsin Department of Radiology suggests the use of Lorazepam (Ativan, Temesta), a short-to-intermediate duration benzodiazepine.
Background: Propofol and pentobarbital are commonly used to sedate children undergoing magnetic resonance imaging (MRI).
Patients with certain conditions that may prevent them from staying still in the MRI machine, such as claustrophobia, anxiety, or any condition that causes physical pain, may qualify for an MRI with sedation. What medications are used? Propofol or Versed will be given through an I.V. to induce conscious sedation.
Before the MRI
You may take all medicines. You may eat and drink unless you are having an MRCP, a specific exam for your gallbladder. You will be asked to fill out a patient history form before your exam.
Some techniques that can reduce the anxiety that comes with feelings of claustrophobia include focused breathing and covering your eyes with a towel during the exam. RAYUS also offers headphones for listening to music and, for Open Upright MRI patients, watching TV is an option.
When not properly accommodated during an MRI, claustrophobic patients may experience panic attacks, which can bring on increased heart rate, difficulty breathing, chills, sweating, and other distressing symptoms.
Diazepam 5 mg po, once for MRI study or Lorazepam 1mg po, once for MRI study. B. For use with adult patients who have a need for an oral sedative for a successful MRI.
Most people who have claustrophobia are able to tolerate the MRI scan in the open, upright MRI machine. This is the structure of most MRI machines that can only perform the imaging studies with the patient lying on their back on a table that is moved into the core of the magnetic field where the images are captured.
Suggested Claustrophobia Anxiety Prophylaxis for MRI
For patients who may experience claustrophobia during an MRI scan and require prophylaxis, the University of Wisconsin Department of Radiology suggests the use of Lorazepam (Ativan, Temesta), a short-to-intermediate duration benzodiazepine.
Counting numbers or listening to music: Counting slowly or listening to a soothing melody can help distract you and make the time pass quickly while you are in the scanner. Talk to the Technician: In most instances, you can speak to the technician throughout most of the procedure.
A CT scan may be recommended if a patient can't have an MRI. People with metal implants, pacemakers or other implanted devices shouldn't have an MRI due to the powerful magnet inside the machine. CT scans create images of bones and soft tissues.
As benzodiazepines offer both sedative and profound amnesic and anxiolytic effects, these drugs are used for conscious sedation worldwide. Diazepam has been the 'gold standard' of sedation, but the more modern benzodiazepines, particularly midazolam, are now more commonly used.
Practice MRI Relaxation Techniques
Meditation: Simple meditation activities like focusing on your breathing or visualizing a calm place help some patients relax. Closing your eyes: Keeping your eyes closed or covering them with a towel can reduce the enclosed feeling that you might experience.
Claustrophobia can be successfully treated and cured by gradually being exposed to the situation that causes your fear. This is known as desensitisation or self-exposure therapy. You could try this yourself using self-help techniques, or you could do it with the help of a professional.
The two main medication classes most often prescribed are: Benzodiazepines, such as the antianxiety drugs alprazolam (Xanax®), clonazepam (Klonopin®) and diazepam (Valium®). Selective serotonin reuptake inhibitors, such as paroxetine (Paxil®) or escitalopram (Lexapro®).
The patient self-administered the lorazepam approximately 5 min before undergoing the MR study, which included IV injection of 15 mL of gadopentetate dimeglumine (Magnevist; Schering). The imaging procedure lasted approximately 1 hour, during which the patient mostly slept.
An MRI machine uses powerful magnets that can attract any metal in your body. If this happens, you could get hurt. It can also damage equipment that's implanted in your body -- a pacemaker or cochlear implant, for instance.
The MRI scan is a very safe procedure. Occasional complications may include: Metal objects (such as jewellery) worn during the scan can cause injury. The powerful magnetic field of the MRI scanner may damage internal metal devices, such as a heart pacemaker.
Advantages of CT Scans
Because this procedure produces results so much faster than an MRI, it is doctors' preferred choice for a scanner for making a diagnosis in an emergency.
Traditional MRI: A traditional MRI machine is a large tube, roughly 23.5 inches in diameter that a patient lays in. Wide Bore MRI: Essentially this is the same as the traditional MRI machine, but it is a little wider—roughly 27.5 inches. The wide bore is ideal for larger patients and those who are claustrophobic.
Of the 54 clinical patients, 31 were given IV diazepam (mean dose, 7.5 mg; range, 2.5-20 mg) with successful scanning in 30 (97%).
A “Wide Bore” Open MRI is much more spacious
Many people who are claustrophobic and feel uncomfortable in traditional MRI machines feel much more comfortable in the wide bore machine.
With its large size and wide opening, the Aera wide-bore MRI offers more comfort for patients, especially those with claustrophobia.