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Sedating Kids During Surgery or Procedures

by Sue Hubbard, M.D.

I received an email from Maria asking a good question about sedating children for an MRI.  She has a young son who is going to have an MRI and is wondering if they will sedate him and if so how it is done.

An MRI (magnetic resonance imaging) is not truly an x-ray which uses ionizing radiation, but rather uses magnetic fields to provide imaging of body structures. It is especially good for providing contrast between soft tissues of the body, particularly the brain and musculoskeletal tissues.

One of the most important factors with an MRI is that the patient has to be extremely still while the MRI is taking place, as movement will distort the images and the doctor will not be able to get an accurate study.  Due to this fact, it is often necessary to sedate young children to ensure that they will not move.

Although there is no pain involved with an MRI, the “magnetic” makes a great deal of noise while the test is being done. It also requires that you lay still inside a tube. Both of these issues  are also scary to children (and at times many adults).

In my experience, in order to ensure a good study,  a child will have IV sedation during the time that they are having their MRI.  This is typically administered either by an anesthesiologist or a certified nurse anesthetist. The anesthesiologist is present while the study is being performed. While a child is having IV sedation, they are not technically “asleep” and do not require a breathing tube or any assisted ventilation.

In case of any emergency or problem with the sedation, the anesthesiologist is present and is ready to provide airway support if needed.  The best thing about IV sedation is that the onset is rapid, and the doctor can titrate the medication to just the amount needed to get through the procedure.  There is very little “down time” once the sedation is stopped and the child can be in and out of the MRI suite and fully awake rather quickly, so this may be done as an outpatient. The “worst” part of IV sedation is the need to start the IV, but pediatric anesthesiologists and nurses have this down to an art, and apply numbing cream before placing the IV, so there is really very little pain involved.

The hardest part is trying to explain all of this to your child prior to the procedure.  Playing with a doll and explaining what will happen prior to going to the hospital is a good way to help way lay some of their fears (and yours too!).   You will really be amazed at the images you will see once your child’s MRI is complete, it is remarkable technology.

That’s your daily dose.  We’ll chat again tomorrow.

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