Masaracchia Melissa M, Tsapakos Michael J, McNulty Nancy J, Beach Michael L
Department of Anesthesiology, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Department of Radiology, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Paediatr Anaesth. 2017 Sep;27(9):880-884. doi: 10.1111/pan.13165. Epub 2017 May 15.
Increasingly complex pediatric patients and improvements in technology warrant reevaluation of the risk associated with anesthesia for diagnostic imaging. Although magnetic resonance imaging is the imaging modality of choice for children given the potentially harmful effects of computerized tomography-associated ionizing radiation, we dare to suggest that certain patients would benefit from the liberalization of our current standard. Incorporating the use of newer computerized tomography technology may improve safety for those that are already at higher risk for adverse events. Furthermore, magnetic resonance imaging is not risk-free-what is often overlooked is the need for controlled ventilation and breath-holding to minimize motion artifact. As physicians at the forefront of the development and sustainability of the perioperative surgical home, anesthesiologists must work to not only optimize patients preoperatively but should also act as gatekeepers for procedural safety.
日益复杂的儿科患者以及技术的进步，使得有必要重新评估诊断成像麻醉相关的风险。尽管考虑到计算机断层扫描相关电离辐射的潜在有害影响，磁共振成像对儿童来说是首选的成像方式，但我们敢提出，某些患者将受益于放宽我们目前的标准。采用更新的计算机断层扫描技术可能会提高那些已经处于不良事件高风险的患者的安全性。此外，磁共振成像并非没有风险——常常被忽视的是需要控制通气和屏气以尽量减少运动伪影。作为围手术期外科之家发展和可持续性前沿的医生，麻醉医生不仅必须努力在术前优化患者状况，还应充当程序安全的把关人。
