Beyond sedation: a narrative review of nonpharmacological innovations for managing patient anxiety in magnetic resonance imaging examinations.

OBJECTIVE

To critically analyze evidence-based alternatives to sedation in patients with radiology-related phobias, focusing on clinical efficacy, feasibility, and implementation challenges.

METHODS

This is a narrative review of the scientific literature published between 1985 and 2025, based on indexed databases (PubMed, Scopus, Embase, Scientific Electronic Library Online, and PsycINFO) and clinical guidelines. We included observational studies, clinical trials, systematic reviews, and expert consensus statements.

RESULTS

Effective nonpharmacological interventions include mock scanner training, cognitive-behavioral therapy, virtual reality exposure, breathing/relaxation techniques, environmental modifications, and therapeutic communication. These approaches significantly reduce the need for sedation, particularly in pediatric, geriatric, and neurodivergent populations. However, implementation remains limited by structural, economic, and cultural barriers.

CONCLUSION

Nonpharmacological strategies are clinically effective and ethically desirable for managing patient anxiety and phobias in the setting of magnetic resonance imaging. Their systematic incorporation requires institutional restructuring, interdisciplinary training, and investment in supportive technology.