Practice Advisory on Anesthetic Care for Magnetic Resonance Imaging

Abstract

The American Society of Anesthesiologists Committee on Standards and Practice Parameters and the Task Force on Anesthetic Care for Magnetic Resonance Imaging presents an updated report of the Practice Advisory on Anesthetic Care for Magnetic Resonance Imaging. Supplemental Digital Content is available in the text.

Anesthetic challenges and outcomes for procedures in the intraoperative magnetic resonance imaging suite: A systematic review

“…This systematic scoping review was conducted to summarize the existing evidence about anesthetic care in iMRI operating rooms. In line with national and international guidelines regarding safe anesthetic care in a magnetic resonance imaging environment [1,67], we found a broad consensus regarding the need for specialized equipment, provider education, patient screening, and emergency preparedness. We identified recurring concerns related to limitations in the reliability or functionality of MRI-compatible equipment, the difficulty to directly assess airway and vascular access sites while the procedure is underway, the increased time requirement for case preparation and adherence to safety protocols, and the relative isolation of the iMRI suite.…”

“…Anesthesia care in a magnetic resonance imaging (MRI) environment poses unique challenges that are well described [1]. However, little evidence exists specific to MRI-guided surgical procedures, although several narrative review articles discuss far-reaching implications for anesthetic care [2][3][4][5][6].…”

The Zurich Checklist for Safety in the Intraoperative Magnetic Resonance Imaging Suite: Technical Note

“…The challenges for the anesthesiology team when caring for patients in the neurosurgical ioMRI suite have recently been summarized 29 and the American Society of Anesthesiologists provides recommendations on anesthetic care during magnetic resonance imaging. 30 Further articles with specific checklists for anesthetic care in the ioMRI environment have also been published, 2,31 including a comprehensive list of equipment to be located outside the 5-Gauss (0.5 T) line. 31…”

Anesthesia and sedation outside of the operating room

“…Other distractions include darkened rooms, high level of noise, heating due to machines, and unintended projectiles. The ASA practice advisory suggests that prior guidelines be supplemented with additional information from the recent scientific literature ( Table 4 ) [ 24 ]. Although potential health hazards are lacking in evidence published to date, it is strongly advised that all anesthesiologists are educated on the unique environment of the MRI suite and screened for the presence of ferromagnetic materials, foreign materials, or implanted devices.…”