Sasao-Takano Mami, Misumi Kan, Suzuki Masayuki, Kamiya Yoko, Noguchi Izumi, Kawahara Hiroshi
Department of Dental Anesthesiology, Tsurumi University School of Dental Medicine, Yokohama, Japan.
Anesth Prog. 2013 Summer;60(2):60-6. doi: 10.2344/0003-3006-60.2.60.
The magnetic resonance imaging (MRI) room is a special environment. The required intense magnetic fields create unique problems with the use of standard anesthesia machines, syringe pumps, and physiologic monitors. We have recently experienced 2 oral maxillofacial surgery cases requiring MRI: a 15-year-old boy with developmental disability and a healthy 5-year-old boy. The patients required complete immobilization during the scanning for obtaining high-quality images for the best diagnosis. Anesthesia was started in the MRI scanning room. An endotracheal intubation was performed after induction with intravenous administration of muscle relaxant. Total intravenous anesthesia via propofol drip infusion (4-7 mg/kg/h) was used during the scanning. Standard physiologic monitors were used during scan pauses, but special monitors were used during scanning. In MRI scanning for oral maxillofacial surgery, general anesthesia, with the added advantage of having a secured airway, is recommended as a safe alternative to sedation especially in cases of patients with disability and precooperative chidren.
磁共振成像(MRI)室是一个特殊的环境。所需的强磁场给标准麻醉机、注射泵和生理监测仪的使用带来了独特的问题。我们最近遇到了2例需要进行MRI检查的口腔颌面外科手术病例:1例是患有发育障碍的15岁男孩,另1例是健康的5岁男孩。为了获得高质量图像以进行最佳诊断,患者在扫描过程中需要完全固定。在MRI扫描室开始麻醉。静脉注射肌肉松弛剂诱导后进行气管插管。扫描期间通过丙泊酚静脉滴注(4 - 7毫克/千克/小时)实施全静脉麻醉。扫描间歇期使用标准生理监测仪,但扫描期间使用特殊监测仪。在口腔颌面外科手术的MRI扫描中,全身麻醉具有确保气道安全的额外优势,尤其对于残疾患者和不配合的儿童,推荐将其作为镇静的安全替代方法。