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

被引:6
|
作者
Schroeck, Hedwig [1 ,2 ]
Welch, Tasha L. [3 ]
Rovner, Michelle S. [4 ]
Johnson, Heather A. [5 ]
Schroeck, Florian R. [1 ,6 ,7 ]
机构
[1] Dartmouth Coll, Geisel Sch Med, 1 Rope Ferry Rd, Hanover, NH 03755 USA
[2] Dartmouth Hitchcock Med Ctr, Dept Anesthesiol, 1 Med Ctr Dr, Lebanon, NH 03756 USA
[3] Mayo Clin, Dept Anesthesiol & Perioperat Med, 200 First St SW, Rochester, MN 55905 USA
[4] Med Univ South Carolina, Dept Anesthesia & Perioperat Med, 165 Ashley Ave,Suite 525CH, Charleston, SC 29425 USA
[5] Dartmouth Coll, Biomed Lib, 1 Med Ctr Dr, Lebanon, NH 03756 USA
[6] White River Junct VA Med Ctr, 275 N Main St, White River Jct, VT 05009 USA
[7] Dartmouth Coll, Dartmouth Inst Hlth Policy & Clin Practice, Geisel Sch Med, Hanover, NH 03755 USA
关键词
AWAKE CRANIOTOMY; INITIAL-EXPERIENCE; OPERATING-ROOM; ELECTRICAL NOISE; GLIOMA SURGERY; MRI; NEUROSURGERY; MANAGEMENT; RESECTION; IMRI;
D O I
10.1016/j.jclinane.2018.10.022
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background and objective: Hybrid operating room suites with intraoperative magnetic resonance imaging enable image guided surgery in a fully functional operating room environment. While this environment creates challenges to anesthetic care, the effects on anesthetic adverse events and outcomes are largely unknown. This systematic scoping review aims to map the existing knowledge about anesthetic care in advanced imaging hybrid operating rooms. Methods: A broad-based literature search was performed using the PubMed (Medline), Embase, Cochrane Library, Web of Science, and Google Scholar databases. References published in English between January 1994 and August 2017 were included. Quality of evidence was assessed using the GRADE guidelines. Results: Forty-seven manuscripts were eligible for data collection. Adverse events were heterogeneously defined across 17 manuscripts and occurred in 0 to 100% (quality of evidence mostly very low). Monitoring difficulty was reported in 4 manuscripts of very low data quality. Interference between the magnet and the electrocardiogram was investigated in 2 manuscripts (quality of evidence low and very low, respectively). None of the reported events appeared to result in long-term patient harm. Author recommendations or a narrative review of the literature were provided in 40 manuscripts. Common safety concerns included lower equipment reliability, inaccessibility of the patient and airway, and the relative isolation of the suite (in relationship to other anesthesia care areas). Most authors also emphasized the importance of safety checklists, protocols, and provider training. Discussion: While intraoperative magnetic resonance imaging hybrid operating rooms are increasingly utilized, the existing literature does not allow estimating adverse event rates in this location. Prospective studies quantifying the effect of the environment on anesthesia outcomes are lacking. Despite this, there is a broad consensus regarding the anesthetic and safety concerns. More research is needed to inform practice standards and training requirements for this challenging environment.
引用
收藏
页码:89 / 101
页数:13
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