Our dwarf son has had multiple MRI’s and CT scans, so we’ve had some extensive experience with anesthesia. In addition, we have had MRI’s and CT scans done as adult LPs. Here’s what you can expect for MRIs without contrast:
The length of the scheduled time for an MRI will be much longer than the actual imaging requires. From getting them out of street clothes and dressed to going under anesthesia and MRI imaging then recovery, it could take an hour or two. They don’t normally allow anyone else in the room, but parents usually are allowed to stay so you can ask. Anesthesia would just be general by gas or injection, just a little. Either way, they usually determine the dosage by weight. They will put earplugs in his ears because even though he’s under anesthesia, your child will be able to hear it. IT IS VERY LOUD!
If the spine is being checked for compression, the actual time in the tube should last about 45 minutes to 1 hour. They should put your child in a gown, but you can ask if it’s okay that he just wears a tank top and elastic shorts. I always prep myself before an MRI and CT scan, wearing usually cool, lightweight clothes without any metal fasteners or jewelry. This way, I don’t have to change into one of those embarrassing hospital gowns that already don’t fit me. It will get hot in the tube, so they need to keep your child cool. Sometimes they will lay a light blanket on top of the patient while they are in the tube. If your young adult child is old enough to not be given anesthesia and endure the procedure, a blanket will help them know to stay still because of the light weight on their skin. For me, this helps with the coldness of the table and to provide the sense of security like a weighted blanket. Sometimes, the tube has a mirror so that the patient can see outside the tube and the technician can see into it. Other MRI centers may also allow you to choose your own music to help you calm down. I’m usually very laid back about the MRI and CT procedures on myself, so I don’t take any mild sedatives or ask for my own music. Though, the MRI sounds like a bad techno song that keeps skipping. I usually cope with the annoying, loud MRI sound and endure it.
The grouchiness is expected after anesthesia. It’s like what the frack just happened to me? Our son always gets like that after anesthesia. Sometimes he hits. Not so good for anyone nearby when he snaps out of the anesthesia.
Things that you may be asked to watch for in the next 24 hours after the anesthesia: vomiting, dizziness, or loss of appetite. You should try to keep your child hydrated during the day so they can get rid of/pee out the anesthesia.
Special Problems Of Anesthesia For Little People
Make sure to also review the Anesthesia Summary with your doctor written by Dr. Judith Hall.
Anesthesia Summary Medical Corner
Dr. Judith G. Hall Prof. – Medical Genetics
University of British Columbia LPBCA Inc.
Medical Resource: Special Problems Of Anesthesia For Little People
With regard to the special problems of anesthesia for Little People, below I have summarized them for you.
There are many different types of disproportionate short stature and each has a specific set of complications which may be associated with that type. However, there are some generalizations that can be made about all types of short stature if surgery is required:
- Remind your physician and anesthesiologist that the dose of both anesthesia and other medications should be related to weight; that Little People do not take the average adult size of medication, but may require much less.
- Little People often have small tracheas or breathing tubes and when intubating, i.e. putting a tube down to breathe for an individual, it may take a smaller tube or a pediatric size tube may be required.
- Many individuals with different types of chondrodystrophies do not have normal bone structure in the neck. Because of this the nerves to the neck can sometimes be squashed if special care is not given to supporting the neck during surgery and when a patient is anesthetized. Thus it is extremely important that the surgeon and anesthesiologist beware of possibility and support the neck and head while the individual is unconscious.
- The joints in chondrodystrophies often do not have full range of motion, and will not completely straighten out. Thus when an individual is anesthetized it is important not to put extra stress on those joints or attempt to straighten them completely.
- Many types of chondrodystrophies are associated with clefts of the palate or submucous clefts. It is important to be aware of these clefts since they may lead to aspiration or incomplete closure on insertion of breathing tubes.
- Many specific types of chondrodystrophy have particular complications to which they may be prone. In achondroplasia for an instance the spinal canal is small, and there is some greater risk of squashing the nerves in the spinal cord.
- Specifically spinal anesthesia should not be used in achondroplasia. This may possibly lead to complications if a pregnant woman with achondroplasia has a cesarean section since the usual anesthesia for cesarean section is a spinal anesthesia. However, it is important that instead, general anesthesia be used in this situation.
- In all chondrodystrophies which affect the spine (spondyloepiphyseal dysplasia, spondylometaphyseal dysplasia, mucopolysaccharidosis) there may be absence of some of the structures of the neck and backbone which can lead to the vertebrae rubbing on each other. Specifically there can be lack of a structure called the odontoid in the high neck region which can lead to squashing of nerves in that area.
- In osteogenesis imperfecta it is easy for bones to break, therefore during surgery or anesthesia it is important that individual with osteogenesis imperfecta may be a little more prone to an unusual reaction with anesthesia where the temperature goes very high, causing fever. The anesthesiologist should monitor for that.
- Sometimes it is hard to start IVs in people with disproportionate short stature since the elbow does not straighten out all the way. Using child sized IVs and “butterfly” equipment is often required both to draw blood and to start an IV line.
The listing of these complications is not intended to frighten any individual who requires surgery, but rather to prepare his/her doctor and anesthesiologist for any possible complication so that the complication can be avoided or treated appropriately.
Also, see the anesthesia article written by Dr. Berkowitz on the LPA National Office website.