Anesthesia can be safely provided for children in a high‐field intraoperative magnetic resonance imaging environment

Abstract

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.

Anesthetic challenges and outcomes for procedures in the intraoperative magnetic resonance imaging suite: A systematic review

“…The included manuscripts mainly consisted of informal (non-systematic) reviews (n=10) [2][3][4][5][6][25][26][27][28][29], institutional experiences (n=10) [30][31][32][33][34][35][36][37][38][39], and case series/retrospective studies (n=12) [40][41][42][43][44][45][46][47][48][49][50][51], with only a few prospective studies (n=4) [52][53][54][55]. We also included 11 references that were published only in abstract form [56][57][58][59][60][61] or case report format [62][63][64][65][66].…”

“…Seventeen manuscripts reported data on adverse events from a total of 2520 cases, which can be further divided into the following broad categories: adverse anesthesia or clinical events (reported in 12 manuscripts, including a total of 1955 cases) [40][41][42][43][44][45][46]53,[55][56][57][58], MRI-related adverse events (reported in 7 manuscripts, including a total of 889 cases) [42,43,[46][47][48]57,59], or technical problems (reported in 5 manuscripts, including a total of 535 cases) [47][48][49]51,53]. We did not examine surgical adverse outcomes or complications, even though those were addressed in some of the included manuscripts, because our research question focused on anesthetic considerations.…”

Challenges in paediatric neurosurgery

“…Used with a frameless navigation system, the iMRI helps localise the lesions and also improve the quality and pseudo real-time assessment of resection during neurosurgery. [22][23][24] The procedure requires the use of MRI-safe equipment, which may have some limitations; the pulse oximeter, electrocardiograph and temperature monitoring may develop movement artefacts. Equipment such as forced-air warming devices, nerve stimulators, fluid warmers and precordial Doppler probes may not be MRI compatible and need to be removed at the time of imaging.…”

Intraoperative MRI for neurosurgical and general surgical interventions

“…No ferrous objects should ever enter the MRI operating room or procedure room because of the risk of being pulled toward the magnet and injuring anyone in its path ( Fig. Thus, anesthesia equipment should be placed beyond the 5-Gauss line [28]. Gauss, which is used to express the flux density produced by a magnetic force, helps to determine closeness and safety.…”