MRI sedation fail - GA for 3yo for scan

[clinellwipe]

Hi, just wanting to hear others’ experiences.

My 3yo DS was supposed to have an MRI of his spine today (had faecal Impaction this year and an xray showed his spine is very wide and this may be causing constipation, they want an MRI to check).

He was given chloral hydrate to make him sleep but it was so disgusting he vomited most of it up. The result being he was drowsy but not able to keep still for MRI (he’s awaiting an assessment for autism and has sensory issues too). So after a whole day of fasting and refusing water (he hates water so he’s now dehydrated too) , and lots of upset at the hospital he is now coming home. He will have the scan under general anaesthetic at some point.

Anyone else’s children not coped well with the oral sedation? Any experiences re a scan under GA? I feel so sorry for him as he’s not able to understand why he’s having to go to hospital and why we’re doing unpleasant things to him :( My husband is an anaethetist and strongly suspected the sedation ‘wouldn’t work’ for one reason or another.

Your husband is a anaesthetist and “strongly suspected” that sedation wouldn’t work

why on earth did you not follow his view

given his expertise I would have completely bowed to his view on this

as for your question, again - surely your husband is amazingly well placed to answer

this is very strange op. Your husband, the child’s father, is an anaesthetist!

The nearest hospital to us that does GA MRIs in young children has a waiting list for them of many, many, many months. So we quite often try with sedation, knowing it's a bit of a toss up whether it will work, but that if it does we've really cut the wait short. Chloral seems to be the sedation option that works best (compared to midazolam, and melatonin, both of which we have tried).

shame about the vomit - sounds like if he'd managed to keep a bit more down he'd might have been ok. As per pp, and as your DH should know, the sedation sometimes works a treat but sometimes doesn't...usually not much lost by trying it though. GA for MRI is usually fairly straightforward. As your DH should also know, we often use different sedative pre-meds the the ones the paediatricians might use if one is needed (it isn't always needed though). MRI can make you feel pretty queasy (independent of the anaesthetic) so that may be something to be aware of.

Yes I could have written your post. Sedation didn’t work, social comms difficulties and hating water. Lots of screaming. She has regular MRIs and they’ve always been under GA since. It’s not pleasant but it’s better than the screaming and wasted day!

A scan under GA is much safer than sedation. You’ve got a full anaesthetic team rather than just a nurse with a grab bag. Their siesta is also properly secured. I’m a pads nurse and we don’t sedate for MRI. It’s a waste of a slot if it doesn’t work. So it’s straight to GA.