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Anaesthesia for MRI in the paediatric patient

Serafini, Gianpaoloa; Zadra, Nicolab

Current Opinion in Anaesthesiology: August 2008 - Volume 21 - Issue 4 - p 499–503
doi: 10.1097/ACO.0b013e328304115b
Anesthesia outside the operating room: Edited by Francis Bonnet
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Purpose of review The purpose of the present review is to focus on the literature in the past year and specifically the development of recent guidelines, the debate on who does the sedation anaesthesia for MRI in a paediatric patient, the use of medications and techniques, and the use of monitors and equipment.

Recent findings The revised guidelines of American Academy of Pediatrics and American Academy of Pediatric Dentistry underline the serious risks associated with the sedation of paediatric patients and emphasize the need for proper preparation and proper evaluation. Most children require deep sedation for MRI and the practitioner must have appropriate skills to rescue the patient from general anaesthesia. In the debate on ‘who does the sedation’, the most important goal is to achieve uniformity in the formal training of the practitioners in key practice elements (airway management, resuscitation, vascular access, medications). Recent findings about the use of anaesthetic techniques, monitors and equipment, and complications are reported.

Summary The MRI suite is a challenging environment for anaesthetists and nonanaesthetists, and has serious risks. A systematic approach, similar to that of anaesthesia provided in the operating room, is mandatory. A well equipped anaesthesia machine, standard monitoring, trained personnel and adequate planning should be standard for all procedures out of the operating room.

aAnaesthesia and Intensive Care Unit 1, IRCCS Foundation, S.Matteo, Pavia University, Pavia, Italy

bAnaesthesia and Intensive Care Unit, Padua Hospital, Padua, Italy

Correspondence to Gianpaolo Serafini, Anaesthesia and Intensive Care Unit 1, IRCCS S.Matteo Hospital, P.le Golgi 2, 27100 Pavia, Italy Tel: +39 0382 502936; fax: +39 0382 502895; e-mail: gp.serafini@yahoo.it

© 2008 Lippincott Williams & Wilkins, Inc.