Stony Brook University Hospital Department of Anesthesiology

Division of Pediatric Anesthesia

Pediatric Anesthesia for MRI

• What role does the pediatric anesthesiologist have in my child's care?
• You probably will not get to know your child's anesthesiologist as well as the primary service physicians. Nonetheless, the anesthesiologist will plays many important roles in your child's care before, during, and after the MRI procedure.
  Specifically, the anesthesiologist:
  1. Continually monitors the vital functions such as breathing, heart rate and rhythm, blood pressure, oxygen saturation, and fluid and blood needs and makes medical decisions.
  2. Ensures the child's safety during the procedure by using anesthetics and techniques, tailored to the specific medical condition.
  3. Manages pain during the immediate post-procedure period to make the child as comfortable as possible.
  Provides consultation on many aspects of the medical care, including medications and airway management.
• Why is there a preoperative interview?
• The preoperative interview has two important purposes.
  The first one is to provide the anesthesiologist with health history so he or she can properly plan and manage your anesthesia and care during and following the procedure.
  The second purpose of the interview is to give you an opportunity to ask questions and voice any concerns you may have.
• What will the anesthesiologist need to know?
• The anesthesiologist will want to make sure that your child is in the best possible physical condition before the procedure. You will be asked about your child's general health, whether there has been any family history of difficulties with anesthesia and what your child's experiences have been with previous anesthetics. During this evaluation, the anesthesiologist will explain the planned anesthetic procedures. The discussion may include whether or not your child will receive anything for sedation before the procedure, and how the anesthetic will be initiated and maintained. This is the best time for you and your child to ask questions and express any concerns to the anesthesiologist.
  You will also be asked about allergies. Sometimes children react to certain medications in odd ways that are not truly allergic reactions but are "labeled" as such
  When you report that your child is allergic to a medication, you will be asked to describe the reaction so that we can determine if there is a true allergy. It is unusual for children to be allergic to anesthetic drugs or to the MRI contrast agent (injected during the study). The most commonly encountered allergies are to antibiotics such as penicillin or amoxicillin.
  Sometimes minor illnesses such as sniffles and colds may cause problems during some types of surgery and anesthesia. For this reason, the anesthesiologist may feel it is best to postpone the procedure. Remember, your child's safety is our first priority.
• Will my child receive any medication before the procedure?
• We now realize that many children need less sedation when calm, assured and confident parents help them through the stress of a procedure or hospitalization. In spite of parents' reassurances, however, some children still may require medicine to calm them before a procedure. This medication may be given by mouth or injection. The time and type of such premedication will vary and will be determined by the anesthesiologist.
• How will my child be given anesthesia?
• Anesthetic agents can be started in several ways. Most commonly in adults, anesthesia is started by an intravenous injection so the patient becomes unconscious rapidly. This is also a method that can be used for children. Another method of beginning anesthesia is to let your child breathe anesthetic agents until losing consciousness. This is called a mask or inhalational induction. With this approach, your child will be asked to breathe through a "space mask" quietly, and no needle sticks will be performed until after your child is sound asleep. The choice of which method to begin anesthesia will be made by the anesthesiologist based on many factors.
• Will my child be asleep during the entire procedure?
• After inducing general anesthesia, the child will not be conscious (aware) during the entire procedure. Be assured that throughout the entire study, the anesthesiologist continually monitors and adjusts the level of anesthesia. Even when sedation is used, there might be some recollection of the MRI suite after the study is over.
• What are the risks of general anesthesia?
• No procedure is without some degree of risk, which your anesthesiologist will discuss with you prior to the MRI study. Fortunately, serious complications such as strokes and deaths from general (or other types of) anesthesia are very rare today, despite the fact that more procedures are being performed on sicker and younger patients than in the past. In the last 10 years, the estimated numbers of deaths attributed to anesthesia (for all types of surgical procedures) have dropped significantly to 1 in 250,000. Serious complications such as strokes and prolonged periods of mechanical ventilation have also declined over the past few decades. The increased safety of general anesthesia is due to many factors, including: safer drugs, more extensive training of anesthesiologists, and national standards of care.
• What are the side effects of general anesthesia?
• Side effects from general anesthesia may occur, but the vast majority are not serious, do not last long, and are treatable. Side effects may include sore throat, headache, back pain, and/or fatigue. Some patients experience nausea or vomiting, but this occurs less frequently than in the past.
• When and where will my child wake up after the operation?
• This depends on many factors, so there is no single answer to that question. Most likely, the child will be awakening in the MRI area immediately after the procedure.