How to perform the perfect voiding cystourethrogram.
Agrawalla S, Pearce R, Goodman TR.
Pediatr Radiol. 2004;34:114-9.
The voiding cystourethrogram (VCUG) examination is a difficult investigation toperform and is a stressful experience for patients and their parents, as well asfor the radiologists, technicians and paediatric radiology nurses involved inthe examination. Despite the VCUG being one of the most commonly performedfluoroscopic procedures in paediatric radiology practice, there is no generalconsensus as to the best way to perform this investigation. This is particularlyconcerning when one considers the potentially high gonadal radiation dosechildren may receive. Because of this, we have undertaken a comprehensiveliterature review of various aspects of the test in order to determine the bestway to perform the VCUG in modern paediatric radiology practice.
Akil I, Ozkol M, Ikizoglu OY, Polat M, Tuncyurek OY, Taskin O, Yuksel H.
Pediatr Nephrol. 2005;20:1106-10.
Micturating cystourethrogram (MCUG) is an imaging technique indicated in the diagnosis and follow-up of many diseases. We investigated the reliability and the efficacy of midazolam and chloral hydrate in sedation and anxiolysis during micturating cystourethrogram. Fifty-three children of similar ages (39 girls, 14 boys, mean age of 5.8±3.5 years) were randomized to midazolam (n=17), chloral hydrate (n=18) and control groups (n=18). Oral midazolam 0.6 mg/kg or chloral hydrate 25 mg/kg or saline were administered to the study groups 15–30 min prior to the urinary catheterization. Brietkopf and Buttner, Frankl and Houpt scales and Spielbergers State Anxiety Inventory and parents impressions were used to assess the level of sedation and anxiety. The Brietkopf and Buttner classification of emotional status and Houpt behavior rating scale demonstrated a significantly better emotional status and sedation in the midazolam group when compared to controls (P=0.01 and P=0.018, respectively). The catheterization was described as a more unpleasant and distressing event by the parents of the control and the chloral hydrate groups when compared to the parents of the midazolam group (P<0.05).>0.05). Vital signs did not change significantly in any child. Sedation with midazolam does not have adverse effects on the results of micturating cystourethrogram, while it reduces the discomfort in children undergoing this radiological technique.
Commentaires: quelques suggestions pour améliorer les conditions de cet examen souvent mal vécu par les enfants et leurs parents. Quelles sont les habitudes de vos collègues radiologues ?
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