Anesthesiological Management in a Non Accessible Environment Anesthesiological Care Flow during Diagnostic and Therapeutic Interventions in the Field of Magnetic Resonance Imaging (MRI)

摘要

Complexities may arise with patient care in the MRI environment wherever sedation or anesthesia is necessary. The minimum number of disciplines involved is three. The situation of a non-constantly accessible environment together with the potential health risks from the magnetic field underline the need for a central coordination with respect to the patient's individual intervention. The major risks encountered concern ferromagnetic objects and their potential to become projectiles within the MRI scanner room. The MRI setting also creates an unavoidable distancing between the patient and the anesthesiologist in combination with a lack of visibility and a lack of access to the patient, with all these factors impacting upon the anesthesia management. Moreover, the patients who require anesthesia in the MRI suite must be provided with the same level of safety and monitoring as in the operating room. Deep sedation and general anesthesia are equivalent and require the same monitoring. MRI-compatible monitors and anesthesia machines, commercially available and preferable, should ideally be equipped with an electrocardiogram, pulse oximetry, non-invasive blood pressure measurement, capnography and/or in- and expiratory gas monitoring. Essential components for patient care include a holding area, MRI compatible equipment and a professional management based on a complex work flow analysis.