What anesthetic alternatives are available for the child with Down syndrome undergoing MRI?

What anesthetic alternatives are available for the child with Down syndrome undergoing MRI?

Premedication for this child may be necessary to facili-tate the induction of anesthesia. Oral midazolam may be considered for premedication. Intramuscular ketamine can be used quite successfully for premedication in the child with Down syndrome. However, the use of ketamine would not be considered an option in this particular patient, on account of his seizure disorder. Parental presence during the induction of anesthesia has been proven to be quite helpful. However, parental presence should not be viewed as a substitute for premedication.

If the airway examination appears normal, then either an inhalation or intravenous induction can be performed. General anesthesia with an endotracheal tube or laryngeal mask airway (LMA) are good options for this patient. Sedation with a propofol infusion may also be considered. The choice of anesthetic technique for the child with Down syndrome will involve similar decision-making as with any patient.