A Single-Center Retrospective Analysis of a Standardized Sedation Protocol for MRI in Children with Achondroplasia: Minimal Complications and Excellent Imaging Quality

<b>Background/Objectives:</b> Achondroplasia, the most common form of skeletal dysplasia, poses significant challenges for procedural sedation due to distinct anatomical and physiological features. This study evaluated the safety, effectiveness, and imaging quality of a standardized sedation protocol for magnetic resonance imaging (MRI) in children with achondroplasia. <b>Methods:</b> We conducted a single-center, retrospective analysis of 22 MRI procedures in 12 pediatric patients. Intravenous midazolam and propofol were used as primary sedatives, with continuous monitoring and standardized dosing. Sedation parameters were compared between children aged <1 year and children aged ≥1 year. <b>Results:</b> The median sedation duration was 35 (25-65) min, and the median recovery time was 9 (5-14) min. No significant differences were found between age groups in midazolam dose (<1 year: 0.15 ± 0.05 mg/kg vs. ≥1 year: 0.13 ± 0.04 mg/kg; <i>p</i> = 0.238), propofol induction (2.26 ± 1.14 vs. 1.80 ± 0.52 mg/kg; <i>p</i> = 0.375), or infusion rate (3.18 ± 2.74 vs. 5.13 ± 2.65 mg/kg/h; <i>p</i> = 0.203), indicating protocol consistency. High-quality images were obtained in all cases. In one case (4.5%), self-limited desaturation to 92% occurred, with no intervention required. No airway instrumentation or other complications were reported. <b>Conclusions:</b> This protocol provides safe, effective, and reproducible sedation in children with achondroplasia, ensuring high-quality MRI with minimal adverse events.