Increased Risk of General Anesthesia for High-Risk Patients Undergoing Magnetic Resonance Imaging

Abstract

Over the last 2 decades, the scope of anesthesia practice has expanded to include remote sites away from the operating room. As the number of diagnostic and therapeutic interventions performed outside the operating room continues to increase, anesthesiologists are being faced with challenges of providing care for more medically complex patients while adapting to fewer resources, with lack of support system commonly available in the operating room. In this article, we present three pediatric cases resulting in poor outcomes, all of which occurred in our MRI suite.

Anesthesia risks associated with pediatric imaging

“…In either model, moving an anesthetized patient from one place to another is logistically challenging and increases the risk. The study Greenberg presented attempted to assess this risk and showed 3 deaths in 11,700 anesthetics, a risk of 1 in 3,900 [3]. But the small numerator in this study makes the real risk hard to evaluate and all three patients had co-morbidities, similar to the Melbourne study.…”

Musculoskeletal Imaging Strategies and Controlling Radiation Exposure

“…The patients weighed less than 7 kg and were considered high anesthetic risk. Their risk of death of 1 in 3,900 was nearly double the risk of intraoperative anesthesia-1 in 7,138 [ 119 ]. Furthermore, some studies in rodents and primates suggest behavioral and learning disorders after administration of anesthesia, but this does not necessarily apply to humans.…”

Initial Experience with the Use of Remote Control Monitoring and General Anesthesia during Radiosurgery for Pediatric Patients

“…Careful preparation in magnetically active environments seems to be more vital than in radioactive fields. While no accidental deaths were reported from the multiple center survey [10], there is one report stating that the mortality risk doubled when general anesthesia was performed in an MRI suite [29]. As the MRI-compatible precise ECG monitor is still unavailable, it has been truly difficult to set everything up like the OR.…”