MRI Sedation Options

[wanderinggypsy]

My dd is now 3 and a half. As a baby, she was diagnosed with Kaposiform Hemagioendothelioma, an aggressive vascular tumor in her chest, back, and neck. She had twenty weeks of chemo and steroids, and improved remarkably. MRIs in that time period indicated that the tumor was regressing. They wanted to do more MRIs, but we held off as she was quite traumatized from medical stuff anyways, and from her symptoms we were confident that the tumor was no longer posing an immediate threat. Her medical team was comfortable with that judgment call.

So now, she's three and half. She has had three MRIs, the last one was when she was about 7 months old. For those early scans, conscious sedation was used. Now she has another MRI booked for next month and I just found out that they have booked general anesthesia. And I'm not really cool with that. If conscious is an option, I don't know why go general. I'll be talking to the clinic coordinator tomorrow, but man, I'm stressed.

I guess general is the more commonly used method? Has anyone ever had anything BUT general used for their kiddo?

Any thoughts on all this would be appreciated.

Thanks.

[2boyzmama]

We used conscious sedation the first time, but have to use general now because they discovered an airway issue with my guy, and he has a history of aspirating.

For med choices, oral chloral hydrate was AWFUL for him, but Versed has been wonderful. We usually give Versed before general, just to calm him, and it usually knocks him nearly out anyway.

We were able to get through a CT scan with no sedation or any kind with the help of Child Life. I was allowed in the room, and we all worked on distracting him. A CT is much quicker than an MRI, but if you think she might be okay with it, you could ask to attempt it that way. If she freaks out, you can stop the test, sedate, and finish it; or reschedule it altogether. Another little one here managed an MRI with no sedation because her parents kept her up all night, kept her hungry, then showed up, nursed her to sleep, and swaddled her tightly and she slept through it.

[Casha'sMommy]

We sedated our little guy for MRI simply because he's wiggly and they've got to remain so still. I didn't see a way around it.
GL

[anj_rn]

I used to be a conscious sedation nurse for a pedi hospital. The majority of my job consisted sedating for MRIs. Depending on the hospital, the meds they use can be different. If an IV is not needed, many hospitals use chloral hydrate, although this works best on little kids (esp if they are sleepy). If an IV is needed for the porocedure, I prefer to use IV sedation. I would ask the hospital what the risk factor is that requires general.

From a hospital perspective, conscious sedation is administered by a RN, and the patient is monitored by that RN during the procedure and while they recover. If the child is considered higher risk (i.e. airway issues, medical problems), the child is sent to the anesthesia team where the meds will be administered by and anesthesiologist & monitored by the anesthesiologist as well. Usually it is a safety concern. I have seen docs from the anesthesia team opt to use lighter sedation after assessing the patient.

I hope all goes well.

[APToddlerMama]

subbing

[BookGoddess]

We've done an MRI on DD using IV Propofol. She was monitored during the MRI. IV sedation worked really fast and she had no problems with it. The recovery was good too. I've heard that some kids come out of other sedation methods thrashing and being really out of it. That wasn't our experience with Propofol. She was back to her normal self in about 40 minutes after recovery.

We've given Versed for another type of noninvasive test. It was awful. Not that she reacted to the drug (she didn't), but it wasn't enough. She was still too conscious and wiggly. That whole experience was actually worse than the MRI with IV sedation because she was traumatized from being aware of the process. With the IV sedation, she had no memory of the procedure so she was much more cooperative in the recovery stage.

[AbbieB]

Originally Posted by BookGoddess

We've done an MRI on DD using IV Propofol. She was monitored during the MRI. IV sedation worked really fast and she had no problems with it. The recovery was good too. I've heard that some kids come out of other sedation methods thrashing and being really out of it. That wasn't our experience with Propofol. She was back to her normal self in about 40 minutes after recovery.

We've given Versed for another type of noninvasive test. It was awful. Not that she reacted to the drug (she didn't), but it wasn't enough. She was still too conscious and wiggly. That whole experience was actually worse than the MRI with IV sedation because she was traumatized from being aware of the process. With the IV sedation, she had no memory of the procedure so she was much more cooperative in the recovery stage.

Going through this stuff now with my just turned 3 year old. My first thought was versed. We have had wonderful results with it. He is agitated for about 15 minutes as it wears off, but I have been able to hold him during this time and he clearly has no memory of anything about the period of time just prior to the procedure to getting out of recovery.

Second choice would be propofol. If I have the right name (I know it started with a p) DS did GREAT with this stuff. It has a short half life so it wear off quickly and seemed to be a smooth transition from sedated to consciousness.

[moongazer]

I think it depends on your child. DD had an MRI when she was 3.5 with no sedation at all. The nurse balked, but I told her I wanted to try. And DD was fine. She is a very quiet, calm child to begin with. This is the child who never once cried during a shot or blood draw. I know that would not work with all kids because they have to hold so still. But it should be an option if you think it might work. Oh, I did bribe her that she could pick out any toy she wanted when it was done, LOL. She picked a Hello Kitty doll.