title: Anesthesia can be safely provided for children in a high-field intraoperative magnetic resonance imaging environment.
abstract: OBJECTIVE
  To describe the challenges associated with providing safe anesthesia and perioperative care for children in a remote intraoperative magnetic resonance (iMR) operating room (OR) and to identify perioperative anesthesia outcomes, including adverse events related to the iMR environment.
  
  
  BACKGROUND
  Increasingly, children undergo neurosurgical procedures in a high-field iMR OR. We describe a 10-year experience of providing anesthesia for children in this environment with a mobile 1.5-Tesla magnet.
  
  
  METHODS
  A 10-year retrospective analysis was conducted of children who underwent neurosurgical procedures in a high-field mobile iMR OR. Primary outcomes related to perioperative adverse events and recovery profiles. Results were expressed as mean ± sd or median (range), as appropriate.
  
  
  RESULTS
  One hundred and five procedures were performed on 98 children, aged 4 months-18 years, weighing 6-112 kg. The commonest two diagnostic categories were tumor (n = 52) and seizures (n = 27). Median anesthetic time was 439 (185-710) mins. There were no significant adverse events related to the iMR environment. The mean postanesthetic care unit admission temperature was 37 ± 0.9°C and the mean modified Aldrete Score at 30 mins was 7.2 ± 0.9. Two patients experienced seizures in the immediate postoperative period, readily controlled with propofol. There was one breach of MR safety protocol, and no adverse events related to patient transport.
  
  
  CONCLUSIONS
  Anesthesia and perioperative care of children in an iMR setting were associated with a very low incidence of complications, despite the duration of the procedures involved. Such success depends upon a cohesive team-based approach.
authors.affiliation: Department of Anesthesia, Faculty of Medicine, University of Calgary, Calgary, AB, Canada. robin.cox@albertahealthservices.ca
authors.forename: Robin G
authors.initials: RG
authors.lastname: Cox
authors.forename: Ron
authors.initials: R
authors.lastname: Levy
authors.forename: Mark G
authors.initials: MG
authors.lastname: Hamilton
authors.forename: Alastair
authors.initials: A
authors.lastname: Ewen
authors.forename: Peter
authors.initials: P
authors.lastname: Farran
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Neil
mesh_terms: D000293:Adolescent; D000758:Anesthesia / Q000009:adverse effects; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D001831:Body Temperature; D001932:Brain Neoplasms / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004574:Electromagnetic Fields; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D016343:Monitoring, Intraoperative; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012449:Safety; D012640:Seizures / Q000601:surgery; D016896:Treatment Outcome