Cox Robin G, Levy Ron, Hamilton Mark G, Ewen Alastair, Farran Peter, Neil Stuart G
Department of Anesthesia, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
Paediatr Anaesth. 2011 Apr;21(4):454-8. doi: 10.1111/j.1460-9592.2011.03528.x. Epub 2011 Feb 8.
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.
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.
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.
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.
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.
描述在偏远的术中磁共振（iMR）手术室为儿童提供安全麻醉和围手术期护理所面临的挑战，并确定围手术期麻醉结果，包括与iMR环境相关的不良事件。
越来越多的儿童在高场强iMR手术室接受神经外科手术。我们描述了在这种环境下使用移动1.5特斯拉磁体为儿童提供麻醉的10年经验。
对在高场强移动iMR手术室接受神经外科手术的儿童进行了为期10年的回顾性分析。主要结果与围手术期不良事件和恢复情况有关。结果在适当情况下以平均值±标准差或中位数（范围）表示。
对98名年龄在4个月至18岁、体重6至112公斤的儿童进行了105例手术。最常见的两个诊断类别是肿瘤（n = 52）和癫痫（n = 27）。中位麻醉时间为439（185 - 710）分钟。没有与iMR环境相关的重大不良事件。麻醉后护理病房入院时的平均体温为37 ± 0.9°C，30分钟时的平均改良Aldrete评分为7.2 ± 0.9。两名患者在术后即刻出现癫痫发作，用丙泊酚很容易得到控制。有一次违反了磁共振安全协议，且没有与患者转运相关的不良事件。
尽管手术时间较长，但在iMR环境下对儿童进行麻醉和围手术期护理的并发症发生率非常低。这样的成功依赖于基于团队的紧密协作方法。
