Abstract
Magnetic resonance imaging (MRI) and computed tomography (CT) are advanced imaging technologies that offer unique diagnostic options for our patients. Due to the high clinical utility of these modalities, the demand for these scans is surging, and these scanner suites are increasingly busy at all hours. Many patients needing MRI or CT scans will require anesthesia services, due to young age, disability, developmental delay, pain, or claustrophobia. MRI and CT locations are potentially challenging environments in which to provide safe anesthetic patient care, due to their remote locations and unique hazards such as strong magnetic fields, ionizing radiation, thermal injuries, and contrast agents. This chapter presents background concepts, safety guidelines, and practical anesthesia options that will facilitate safe and efficient anesthetic care of pediatric and adult patients in these unusual imaging environments. Table 25.1 provides a summary of anesthesia considerations in patients undergoing MRI and CT imaging.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Metzner J, Posner KL, Domino KB, et al. The risk and safety of anesthesia at remote locations: the US closed claim analysis. Curr Opin Anaesthesiol. 2009;22:502–8.
Expert Panel on MR Safety, Kanal E, Barkovich AJ, Bell C, et al. ACR guidance document on MR safe practices: 2013. J Magn Reson Imaging. 2013;37:501–30.
The Joint Commission. Preventing accidents and injuries in the MRI suite. Sentinel Event Alert, Issue 38; 14 Feb 2008. http://www.jointcommission.org/assets/1/18/SEA_38.pdf. Accessed 24 March 2017.
ASTM International. Standard practice for marking medical devices and other items for safety in the magnetic resonance environment. Designation: F2503-13. West Conshohocken; 2013.
Philbin MK, Taber KH, Hayman LA. Preliminary report: changes in vital signs of term newborns during MR. AJNR Am J Neuroradiol. 1996;17:1033–6.
International Commission on Non-Ionizing Radiation Protection, Vecchia P, Hietanen M, Ahlbom A, et al. Guidelines on limits of exposure to static magnetic fields. Health Phys. 2009;96:504–14.
Hartwig V, Giovannetti G, Vanello N, et al. Biological effects and safety in magnetic resonance imaging: a review. Int J Environ Res Public Health. 2009;6:1778–98.
Dalal PG, Porath J, Parekh U, et al. A quality improvement project to reduce hypothermia in infants undergoing MRI scanning. Pediatr Radiol. 2016;46:1187–98.
Brown TR, Goldstein B, Little J. Severe burns resulting from magnetic resonance imaging with cardiopulmonary monitoring: risks and relevant safety precautions. Am J Phys Med Rehabil. 1993;72:166–7.
Martinez J, Ferraro S, Siemaszko C. Freak MRI accident kills W’Chester boy. New York Daily News; 31 July 2001.
Shellock FG. Reference manual for magnetic resonance safety, implants and devices: 2015 edition. Los Angeles: Biomedical Research Publishing Group; 2015.
Levine GN, Gomes AS, Arai AE, et al. Safety of magnetic resonance imaging in patients with cardiovascular devices: an American Heart Association scientific statement from the Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology, and the Council on Cardiovascular Radiology and Intervention. Circulation. 2007;116:2878–91.
Practice advisory on anesthetic care for magnetic resonance imaging: an updated report by the American Society of Anesthesiologists Task Force on Anesthetic Care for Magnetic Resonance Imaging. Anesthesiology. 2015;122:495–520.
Roberts DC, Marcelli V, Gillen JS, et al. MRI magnetic field stimulates rotational sensors of the brain. Curr Biol. 2011;21:1635–40.
Prince MR, Arnoldus C, Frisoli JK. Nephrotoxicity of high-dose gadolinium compared with iodinated contrast. J Magn Reson Imaging. 1996;6:162–6.
Marckmann P, Skov L. Nephrogenic systemic fibrosis: clinical picture and treatment. Radiol Clin North Am. 2009;47:833–40.
ASA Statement on nonoperating room anesthetizing locations. Approved by the ASA House of Delegates on October 19, 1994, and last amended on October 16, 2013. Schaumburg: American Society of Anesthesiologists.
ASA Standards on basic anesthetic monitoring. Approved by the ASA House of Delegates on October 21, 1986, last amended on October 20, 2010, and last affirmed on October 28, 2015. Schaumburg: American Society of Anesthesiologists.
Coté CJ, Zaslavsky A, Downes JJ, et al. Postoperative apnea in former preterm infants and inguinal herniorrhaphy: a combined analysis. Anesthesiology. 1995;82:809–22.
Malviya S, Voepel-Lewis T, Eldevik OP, et al. Sedation and general anaesthesia in children undergoing MRI and CT: adverse events and outcomes. Br J Anaesth. 2000;84:743–8.
Sanborn PA, Michna E, Zurakowski D, et al. Adverse cardiovascular and respiratory events during sedation of pediatric patients for imaging examinations. Radiology. 2005;237:288–94.
De Sanctis Briggs V. Magnetic resonance imaging under sedation in newborns and infants: a study of 640 cases using sevoflurane. Pediatr Anesth. 2005;15:9–15.
Heard C, Harutunians M, Houck J, et al. Propofol anesthesia for children undergoing magnetic resonance imaging: a comparison with isoflurane, nitrous oxide, and a laryngeal mask airway. Anesth Analg. 2015;120:157–64.
Wu J, Mahmoud M, Schmitt M, et al. Comparison of propofol and dexmedetomedine techniques in children undergoing magnetic resonance imaging. Pediatr Anesth. 2014;24(8):813.
Antonov NK, Ruzal-Shapiro CB, Morel KD, et al. Feed and wrap MRI technique in infants. Clin Pediatr. 2016. https://doi.org/10.1177/0009922816677806.
Golan A, Marco R, Raz H, et al. Imaging in the newborn: infant immobilizer obviates the need for anesthesia. Isr Med Assoc J. 2011;13:663–5.
Pearce MS, Salotti JA, Little MP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet. 2012;380:499–505.
The Joint Commission. Radiation risks of diagnostic imaging. Sentinel Event Alert, Issue 47; 24 Aug 2011. http://www.jointcommission.org/assets/1/18/SEA_47.pdf. Accessed 24 March 1973.
Andreucci M, Solomon R, Tasanarong A. Side effects of radiographic contrast media: pathogenesis, risk factors, and prevention. Biomed Res Int. 2014;2014:741018.
Davenport MS, Cohan RH, Ellis JH. Contrast media controversies in 2015: imaging patients with renal impairment or risk of contrast reaction. AJR Am J Roentgenol. 2015;204:1174–81.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Weller, G.E.R. (2018). Anesthesia for MRI and CT. In: Goudra, B., et al. Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-74766-8_25
Download citation
DOI: https://doi.org/10.1007/978-3-319-74766-8_25
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-74765-1
Online ISBN: 978-3-319-74766-8
eBook Packages: MedicineMedicine (R0)