In recent years, the use of magnetic resonance imaging (MRI) has extended into the operating theatre, especially in the field of neurosurgery. By providing real-time images during surgery, intra-operative MRI (iMRI) facilitates safer and more complete brain tumour resection. However, the iMRI environment poses additional challenges to the anaesthetist when managing intra-operative cardiovascular events. Through three case examples, this article will discuss the issues of cardiovascular resuscitation, cardiac pacing and cardiovascular monitoring in the iMRI environment.
BradleyWG. Achieving gross total resection of brain tumors: Intraoperative MR imaging can make a big difference. ANJR Am J Neuroradiol2002;23(3):348–9.
2.
BlackPMMoriartyTAlexanderEIIIStiegPWoodardEJGleasonPL. Development and implementation of intraoperative magnetic resonance imaging and its neurosurgical applications. Neurosurgery1997;41(4):831–45.
Practice advisory on anesthetic care for magnetic resonance imaging: A report by the Society of Anesthesiologists Task Force on Anesthetic Care for Magnetic Resonance Imaging. Anesthesiology2009;110(3):459–79.
5.
MartinET. Can cardiac pacemakers and magnetic resonance imaging systems co-exist?Eur Heart J2005;26(4):325–7.
6.
LevineGNGomesASAraiAEBluemkeDAFlammSDKanalE. Safety of magnetic resonance imaging in patients with cardiovascular devices: An American Heart Association scientific statement from the Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology, and the Council on Cardiovascular Radiology and Intervention: Endorsed by the American College of Cardiology Foundation, the North American Society for Cardiac Imaging, and the Society for Cardiovascular Magnetic Resonance. Circulation2007;116(24):2878–91.
The Association of Anaesthetists of Great Britain and Ireland. MRI – Provision Of Anaesthetic Services In Magnetic Resonance Units, 2002. [Accessed July 10, 2009.] Available at http://www.aagbi.org/sites/default/files/mri02.pdf.
9.
ArcherDManninenPMcTaggart-CowanRA. Anesthetic considerations for neurosurgery using intraoperative magnetic resonance imaging. Techniques in Neurosurgery2002;7(4):308–12.