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Anesthesia can be safely provided for children in a high‐field intraoperative magnetic resonance imaging environment
Author(s) -
Cox Robin G.,
Levy Ron,
Hamilton Mark G.,
Ewen Alastair,
Farran Peter,
Neil Stuart G.
Publication year - 2011
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2011.03528.x
Subject(s) - medicine , perioperative , propofol , anesthesia , adverse effect , magnetic resonance imaging , anesthetic , retrospective cohort study , incidence (geometry) , emergency medicine , surgery , radiology , physics , optics
Summary Objectives: To describe the challenges associated with providing safe anesthesia and perioperative care for children in a remote intraoperative magnetic resonance (iMR) operating room (OR) and to identify perioperative anesthesia outcomes, including adverse events related to the iMR environment. Background: Increasingly, children undergo neurosurgical procedures in a high‐field iMR OR. We describe a 10‐year experience of providing anesthesia for children in this environment with a mobile 1.5‐Tesla magnet. Methods: A 10‐year retrospective analysis was conducted of children who underwent neurosurgical procedures in a high‐field mobile iMR OR. Primary outcomes related to perioperative adverse events and recovery profiles. Results were expressed as mean ± sd or median (range), as appropriate. Results: One hundred and five procedures were performed on 98 children, aged 4 months–18 years, weighing 6–112 kg. The commonest two diagnostic categories were tumor ( n = 52) and seizures ( n = 27). Median anesthetic time was 439 (185–710) mins. There were no significant adverse events related to the iMR environment. The mean postanesthetic care unit admission temperature was 37 ± 0.9°C and the mean modified Aldrete Score at 30 mins was 7.2 ± 0.9. Two patients experienced seizures in the immediate postoperative period, readily controlled with propofol. There was one breach of MR safety protocol, and no adverse events related to patient transport. Conclusions: Anesthesia and perioperative care of children in an iMR setting were associated with a very low incidence of complications, despite the duration of the procedures involved. Such success depends upon a cohesive team‐based approach.