Henrichs Bernadette, Walsh Robert P
Goldfarb School of Nursing, Barnes-Jewish College, St Louis, Missouri, USA.
AANA J. 2011 Feb;79(1):71-7.
Intraoperative magnetic resonance imaging (IMRI) for tumor resection allows a neurosurgeon to pinpoint the exact location of the tumor before resection and to navigate to the tumor after the incision is made. Although the anesthetic management is not substantially different from that for other neurosurgical procedures, strategies to keep the patient and operating room personnel safe can be challenging. Because of the risk of injury by the strong force of the magnet, safety precautions with respect to anesthetic delivery must be taken. Ferrous objects must be removed and kept outside the operating room. Only MRI-compatible equipment is allowed in the MRI operating room. This includes the anesthesia machine, anesthesia cart, intubating equipment, monitors, stethoscopes, poles for intravenous solutions, and body warmers. Surgical equipment and instruments must be MRI-compatible. Absolute contraindications to entering the MRI suite include pacemakers, cochlear implants, certain cranial aneurysm clips, and metal joints or implants. Goals of anesthesia delivery during IMRI procedures include the following: (1) promoting the safety of patients and staff, (2) preventing MRI-associated accidents, (3) identifying potential equipment-related hazards, (4) recognizing limitations of physiologic monitoring, and (5) acknowledging other potential hazards such as noise.
术中磁共振成像（IMRI）用于肿瘤切除，可使神经外科医生在切除肿瘤前精确确定肿瘤的位置，并在切开后引导至肿瘤部位。尽管麻醉管理与其他神经外科手术的麻醉管理没有实质性差异，但确保患者和手术室人员安全的策略可能具有挑战性。由于存在因磁铁强力导致受伤的风险，必须采取关于麻醉给药的安全预防措施。含铁物体必须移除并放在手术室之外。MRI手术室只允许使用与MRI兼容的设备。这包括麻醉机、麻醉推车、插管设备、监护仪、听诊器、静脉输液杆和保暖器。手术设备和器械必须与MRI兼容。进入MRI室的绝对禁忌证包括起搏器、人工耳蜗、某些颅内动脉瘤夹以及金属关节或植入物。IMRI手术期间麻醉给药的目标包括以下几点：（1）提高患者和工作人员的安全性，（2）预防与MRI相关的事故，（3）识别潜在的设备相关危险，（4）认识生理监测的局限性，以及（5）认识到其他潜在危险，如噪音。
