Pediatric Sedation

Question: I am a mother of a 5 year old who has been scheduled for an MRI. How do you decide whether sedation is needed, and is it possible to come to the department without much notice for sedation if my son, who is usually calm and easygoing suddenly freaks out under the MRI scanner?

Answer: Thank you for contacting the Pediatric Imaging Ask an Expert forum. The decision of whether or not to use sedation for MRI in children depends on the child’s age and his/her ability to hold still for the scan. Even a simple MRI usually takes at least 30 minutes to perform, and many MRIs take an hour or more. That is a long time for a young child to hold still. Children age 7 and over often can cooperate well enough without sedation. Children under the age of two can sometimes be managed with mild oral or IV sedation. Children between the ages of 2 and 7 usually will need heavier sedation or general anesthesia in order to get a good MRI examination. Sedation can be given to young children for short (less than one 1 1/2 hour) scans. The sedation would be scheduled through the anesthesia scheduling office by the doctor’s office. If the child is unexpectedly unable to go through with the scan, the MRI would need to be re-scheduled, and the anesthesia office contacted. The patient cannot get sedation during an MRI without prior notice, because there is a preparation for anesthesia involved, including fasting for several hours before the procedure. With all sedation, the patient is given extra oxygen and the patient’s breathing and vital signs are monitored during the procedure. If lighter “sedation” does not work for a given child, we would have to change the plan, and use general anesthesia which puts the patient into a deeper sleep and involves placing an airway device to assist the patient’s breathing.