MRI (Magnetic Resonance Imaging)

Anesthesia Implications

Position: Supine, arms free at side
Time: 30-60 min (short)

Post-op Pain: Zero
Maintenance Paralytic: No

Anesthetic Approaches

  • GLMA
  • GETT
  • Mask Induction, Propofol Drip
The Anesthesia

No metal – The biggest consideration here is making sure you, the patient, and any equipment are free of metal in the MRI room. Question the patient about any implants they have (eg.neurostimulators, cochlear implants, pacemakers, surgical clips, infusion pumps, etc).

Induction is usually done outside the MRI suite and then patient and monitors are transported into the room.

Line management – The patient will be moved back and forth out of the MRI. Make sure to have all the extensions you need on the ETT/LMA/IV/etc. A good approach is to use an accordion on the ETT and tape it at about the abdomen with the iv and monitor lines.

Come prepared – many MRI rooms are displaced considerably from anesthesia supplies. You may need to come with the supplies/drugs you need to induce and handle any emergencies. Head MRI/CT may be a queue of seizure history. Increased ICP or reduced intracranial compliance calls for ETT placement. Consider having a video laryngoscope available (esp. in cases where C-spine mobility is compromised)

The Surgery

Contraindications: Metal coils/clips.
Possible Contraindications: Pacemakers, heart valves, Upper respiratory infection (may postpone the procedure for 3-4 weeks). Not sure about a possible contraindication? Best to ask the radiologist.

References: Jaffe. Anesthesiologist’s manual of surgical procedures. 15th edition. 2014.