Objective: To examine the impact of a non-invasive strategy, such as a customized play activity, in reducing the need for sedation in young children undergoing diagnostic magnetic resonance imaging (MRI).

Methodology: A randomized controlled trial design was used. All children (4-7 yrs) undergoing diagnostic MRI at the department of paediatrics of a tertiary care hospital were eligible for enrolment. The exclusion criteria included history of development delay, previous MRI scan, and acute traumatic or painful condition. A total of 164 children (83 in control and 81 in intervention arm) were recruited. The intervention involved familiarization with MRI procedure and scanner using a mock scanner, training the child to stay motion free in the machine, and providing the child multiple trial-runs of the MRI imaging with a favoured toy.

Results: The two groups of children were matched on age, gender, and education level of the mother. The percentage of children receiving sedation in the intervention group was 49.4% and this was lower than the control group (63.8%), however, the difference did not approach statistical significance (χ²=3.5, P=0.06). Comparison of the groups on the secondary outcome measure of ease of performing scan by the ratings of a radiologist, blinded to group status, revealed that a significantly higher proportion of the intervention group scans were reported to be easy or extremely easy, relative to the control group (χ²=10.83, P= 0.013).

Conclusion: The study underscores the need for using a child-centric approach in diagnostic testing as this considerably improves family satisfaction and reduces need for sedation.