Sedation for MRI

[TheOldSwitch]

Any experience of teens having sedation for MRIs? I once had light sedation for a camera down my throat and honestly it did bugger all for me!

They say to turn up to the ward 2 hours before the scan. If they give her the injection that early then won't it wear off by the time she needs it?

Will she be flat out fast asleep or still awake?

My other concern is having a wee. She has had trouble with interoception before due to autism. Will she be so deep asleep she could pee herself? Or will she be awake enough to get up and use the loo if I remind her?

My hospital does MRI scans under general anaesthetic rather than sedation as it’s safer and means they definitely keep still. No risk of sedation failure and the scan not getting done.

My son has had loads of mri scans. He tried it once with sedation when he was 6 but he spat the medicine out because it tasted so awful so we had to come back 2 days later so he could have it done under general anaesthetic.

Don't appologise, some of us need medication. The first time I went for an MRI I didn't get as far as being put in the 'tunnel'.

I did some hypnotherapy and my GP prescribed me some Valium.

The radiographer (he was so calming) said if I couldn't do the whole thing they could get the most important details
It might be worth asking if they can give her a break at some point before the panic sets in?

“demanding”?

Didn't you understand my post?

My child has been having very long MRIs since they were around 3 or 4 years old - the first time they just gave her light oral sedation which did wear off and it was awful and she was incredibly distressed

subsequent MRI I have always requested full sedation - so an oral relaxant an hour or before and then full GA when she is ready to go in - her MRIs can last 90 mins to 2 hours

That sounds absolutely appalling, the poor thing.
How does it work in relation to moving about, I thought it was necessary to stay stock still for the entire thing?

I couldn’t do it for ten minutes, never mind anything more.

MRIs are not pleasant but a teen should manage to stay still. I was given headphones.

My 9 yr old also had mri under GA. It was more traumatic for us as just getting to hospital is traumatising for my child. We had sedatives at home, when we got to hospital he was so distressed they gave ketamine, then I held him down on bed so they could knock him out.

He had mri, lumbar puncture, bloods taken wtc.

We had contact and support from learning disability team and play therapists.

I would try and get in touch with the ward and play therapy team and LD team and see what plan you can come up with. We had a private room, LD nurse, x2 and play therapist. They provided toys, various options so I weighed him at home. They didnt take temp, or blood pressure or anything unto he was knocked out, they simply couldn't due to distress.

They offered music, dim lighting, specisl pictures, all sorts of sensory accomodations etc. So they can do allsorts.

People really need to read the ops posts before they reply.

GA MRI is not an option in a lot of hospitals due to the specialised kit required to do it safely and the waiting lists are often long at the hospitals that do do it. Deep sedation in the MRI scanner also comes with risks (including not being able to monitor/get to a patient if they obstruct their airway) so isn't always the best option. If a department has a light sedation protocol that works well most of the time for them then that's usually worth trying before joining the queue for a GA.

@KilkennyCats
yes it’s awful - the first time I actually had to sit next to the machine for 90 mins - with no earphones - I can’t forget the noise - the first time when it was light oral sedation she did move around a bit - bizarrely they’d just pause the machine and ask me to readjust her leg or something (not entirely sure that it is correct procedure but I don’t think they wanted to risk starting all over again!) as there was a long wait list of patients and she was on an emergency list with hardly any Pediatric radiographers available
she has to have brain to toe scans done with contrast dye so that’s why they take so long

now they are scheduled in advance so we can ensure she has the GA

Unfortunately the fact that she's a very tall teenager causes nurses to assume she's capable of much more than she actually is. The sedation didn't go well, midazolam barely affected her and the nurses told us it often doesn't work for teens. Then why was it prescribed or recommended?!

The thing that really grinds my gears is the lack of bedside manner towards my child. A younger child would get far more reassurance and kind words but the nurse who went into the MRI with her barely spoke. I later found out my child was crying her eyes out and begging to stop the test but the nurse just ignored her. Given how red her eyes were and how distressed she was when she came out of the room I believe my daughter is telling the truth.

If anyone with autistic or anxious teens finds this thread in the future I urge you to ring the ward ahead of your appointment and discuss whether the medicine of choice tends to work for teens or not. The nurses all told me it "usually makes teens more agitated and only really works for little kids under 5". Nobody told me that beforehand or I would have pushed for a general anesthetic. Lesson learned.

And to those posters who failed to read my explanations, stop being judgey and consider some teens have greater needs than the ones you've encountered in your life. Neurodiversity and SEND can greatly affect a teenagers maturity level and ability to cope - not all autistic folks are created equal either, so the idea that your son or daughter is autistic and would cope is absolutely irrelevant to the experiences of my child.

God, I hope she’s ok, op? That sounds like my worst nightmare, and I’m not a teenager.
Did they at least get what they needed?

I think they will know what to do about the loo etc - they would have seen it all

try to stop
worrying

OP that sounds awful,your poor dd,I'm so sorry she went through that 😢

Try and read the OP's posts if you can't read the whole thread, if you press on SEE ALL on the OP,it will throw them all up.

I'm not actually sure if they did! If she was sobbing then presumably her body would move a bit. I guess the consultant will let us know at our next appointment.

Go away - your not the post police 👮

she can obv just ignore any posts

That told me, I was trying to be helpful 🙄🤣

The protocol for sedation is midazolam, if it doesn’t work then the only option is really a GA as deeper sedation isn’t particularly safe. I’ve taken many kids for sedated CT scans. But no way would I take a sedated MRI scan. Too long and not able to monitor enough.

Gosh, there’s a lot of misinformation and assumptions in some of these answers!

We do GA for scans when people can’t cope with the MRI, but if the team that are caring for your daughter, and know her, recommend sedation then it’s likely to be the best option for her. The best thing you can do is ring up and ask if she’s having IV or oral sedation. Regarding the incontinence, if they say she’ll be that deeply asleep then a pad is probably the best bet, again, the staff are the best people to discuss this with. She won’t be able to get up and go to the loo mid-scan, so if she’s worried about wetting herself a big pad/adult nappy is probably a good idea.

Please don’t feel you can’t ask questions in advance, staff in MRI are fully aware of how stressful this can be and we would always rather be prepared and able to give you the support you need to get your scan done, it’s so frustrating for everyone when a patient turns up for their appointment and can’t be scanned because they didn’t want to bother us by asking questions in advance.

I appreciate your efforts @TeaRoseTallulah x

midazolam can work absolutely fine in teens - that sounds like a really unhelpful comment if the nurse said it doesn't usually work. There are a small proportion of patients of all ages for whom it can cause agitation - the only way to find out though is to give it and see what happens - can happen with small kids, teens and adults. It often works a treat for the older kids we need to give sedative pre-meds to for theatre (which isn't that unusual in the mid-teens because they're often really nervous about anything in hospital). Sedation in the scanner has to be very protocolised to keep it safe so there is limited scope for polypharmacy and high doses. Hope they managed to get enough pics to see whichever bit they were looking for.

lost a sentence in my last post... If the benzos don't do the job then that clearly needs to be managed kindly and sensibly - sometimes we do just have to bail out and try again in another way/on a different day depending on how urgent things are etc. It works well often enough though that that isn't that common to need to bail.