Risk factors and outcomes of respiratory complications during procedural sedation for paediatric magnetic resonance imaging: A retrospective cohort analysis

Background and Aims: Procedural sedation is essential for achieving diagnostic-quality Magnetic Resonance Imaging (MRI) in children. Respiratory complications are the most frequent adverse events during such sedation, posing a significant safety risk. A detailed understanding of their incidence and predictors is vital for optimising patient selection and sedation protocols. This retrospective cohort was aimedto determine the incidence, identify independent risk factors, and describe the management and clinical outcomes of respiratory complications in children undergoing MRI under sedation.Materials and Methods: We conducted a retrospective cohort analysis of 380 paediatric patients (aged 1–12 years) who underwent MRI under sedation between January 2024 and October 2025. Data on demographics, ASA physical status, sedation drug regimens, and the occurrence of predefined respiratory events (oxygen desaturation [SpO₂ < 92% for >15 seconds], upper airway obstruction, apnoea [>20 seconds], and laryngospasm) were collected from electronic anaesthesia records. Multivariable logistic regression was used to identify independent risk factors.Results: The overall incidence of respiratory complications was 7.6% (29/380). The most common events were oxygen desaturation (3.9%) and upper airway obstruction (1.8%). Multivariable analysis identified age