Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients

Uzumcugil, Filiz; Akca, Basak; Ankay Yilbas, Aysun; Karagoz, Ayse Heves; özen, özge

doi:10.17826/cumj.1125733

Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients

Özge Özen, (Hacettepe Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara, Türkiye)

Filiz Üzümcügil, (Hacettepe Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara, Türkiye)

Aysun YILBAŞ, (Hacettepe Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara, Türkiye)

Başak Akça, (Hacettepe Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara, Türkiye)

Ayse Heves Karagoz (Hacettepe Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Ankara, Türkiye)

Cukurova Medical Journal

2 0

Yıl: 2022 Cilt: 47 Sayı: 4 Sayfa Aralığı: 1455 - 1462 Metin Dili: İngilizce DOI: 10.17826/cumj.1125733 İndeks Tarihi: 09-01-2023

Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients

Öz:

Purpose: The aim of this study was to investigate complications during sedation of pediatric patients undergoing Magnetic Resonance Imaging (MRI) to determine precautions to take to minimize complications while providing a safer environment for patients and healthcare workers. Materials and Methods: The files of consecutive patients taken for 6 months in the MRI unit of our hospital were reviewed retrospectively, and a total of 122 pediatric patients were included. Primary parameter in the study is set as peroperative and postoperative complication incidence. Interventions to treat, demographic data, ASA scores, accompanying diseases, agents and their doses for sedation, sedation and recovery time are the secondary parameters and their correlation to complication incidence is assessed. Results: Using the data of 122 patients, complication rate is found as 6.6% (8/122). During sedation, desaturation in 6, bradycardia and desaturation in 1 and airway obstruction in 1 of the patients was observed. Desaturation was seen in 2, bradycardia was seen in 1 of the patients during recovery. Use of ketamine didn’t decrease the dose of midazolam or propofol used for maintenance but decreased the dose of propofol used for induction. Conclusion: Complications may occur despite the presence of an experienced anesthesia team. It is important to anticipate such complications and intervene in a timely manner.

Anahtar Kelime: MRI non-operating room anesthesia complication

Pediatrik hastalarda manyetik rezonans görüntüleme sırasında anestezi uygulamalarında görülen komplikasyonların insidansı

Öz:

Amaç: Çalışmamızda, Manyetik Rezonans Görüntüleme (MRG) Ünitesi’nde anestezi altında görüntüleme yapılan pediatrik hastalarda, uygulanan sedasyona bağlı gelişen komplikasyonları inceleyip; bu komplikasyonları daha aza indirmek için gereken önlemleri tespit ederek, hasta ve sağlık personeline daha güvenli bir ortam sağlanması amaçlanmıştır. Gereç ve Yöntem: MRG Ünitesi’nde 6 ay boyunca alınan hastaların dosyaları retrospektif olarak incelenip, toplam 122 pediatrik hasta çalışmaya dahil edilmiştir. Çalışmadaki birincil parametre, peroperatif ve postoperatif komplikasyon insidansı olarak belirlenmiştir. Bu komplikasyonlara olan müdahale yöntemleri, demografik verileri, ASA skorları, eşlik eden hastalıkları, kullanılan anestezik ajanlar ve dozları, sedasyon ve derlenme süreleri ikincil parametreler olarak incelenmiş; komplikasyon insidansı ile korelasyonları değerlendirilmiştir. Bulgular: Toplam 122 hastaya ait veriler çalışmaya dahil edilmiş; komplikasyon oranı %6.6 (8/122) olarak tespit edilmiştir. Sedasyon süresince; 6 hastada desaturasyon, 1 hastada bradikardi ve desaturasyon, 1 hastada havayolu obstrüksiyonu saptanmıştır. Derlenme sırasında, 2 hastada desaturasyon, 1 hastada bradikardi gelişmiştir. Ketamin kullanılan hastalardaki diğer anestezik ajanların dozlarında herhangi bir azalma olup olmadığı incelendiğinde midazolam dozunun ve idamede kullanılan propofol dozunun azalmadığı; ancak, indüksiyonda kullanılan propofol dozunun anlamlı şekilde azaldığı görülmüştür. Sonuç: MRG için anestezi sırasında, deneyimli bir anestezi ekibinin varlığına rağmen komplikasyonlar oluşabilir. Bu tür komplikasyonların öngörülmesi ve zamanında müdahale edilebilmesi için hazırlıklı olmak önemlidir.

Anahtar Kelime: MRG ameliyathane dışı anestezi komplikasyon

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Maddirala S, Theagrajan A. Non-operating room anaesthesia in children. Indian J Anaesth. 2019;63:754-62.
2. Sethi D, Gupta M, Subramanian S. A randomized trial evaluating low doses of propofol infusion after intravenous ketamine for ambulatory pediatric magnetic resonance imaging. Saudi J Anaesth. 2014;8:510-6.
3. Tith S, Lalwani K, Fu R. Complications of three deep sedation methods for magnetic resonance imaging. J Anaesthesiol Clin Pharmacol. 2012;28:178-84.
4. Weissend EE, Litman RS. Paediatric anaesthesia outside the operating room. Curr Opin Anaesthesiol. 2001;14:437-40.
5. Practice advisory on anesthetic care for magnetic resonance imaging: an updated report by the american society of anesthesiologists task force on anesthetic care for magnetic resonance imaging. Anesthesiology. 2015;122:495-520.
6. Serafini G, Ongaro L, Mori A, Rossi C, Cavallora F, Tagliaferri et al. Anesthesia for MRI in the paediatric patient. Minerva Anestesiol. 2005;71:361-6.
7. Missant C, Van de Velde M. Morbidity and mortality related to anaesthesia outside the operating room. Curr Opin Anaesthesiol. 2004;17:323-7.
8. Couloures KG, Beach M, Cravero JP, Monroe KK, Hertzog JH. Impact of provider specialty on pediatric procedural sedation complication rates. Pediatrics. 2011;127:e1154-60.
9. Van de Voorde P. European Paediatric Advanced Life Support. Niel, European Resuscitation Council Vzw, 2015.
10. Melloni C. Morbidity and mortality related to anesthesia outside the operating room. Minerva Anestesiol. 2005;71:325-34.
11. Biber JL, Allareddy V, Allareddy V, Gallagher SM, Couloures KG, Speicher DG et al. Prevalence and predictors of adverse events during procedural sedation anesthesia-outside the operating room for esophagogastroduodenoscopy and colonoscopy in children: age is an independent predictor of outcomes. Pediatr Crit Care Med. 2015;16:e251-9.
12. Cravero JP, Blike GT, Beach M, Gallagher SM, Hertzog JH, Havidich JE et al. Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the pediatric sedation research consortium. Pediatrics. 2006;118:1087-96.
13. Gozal D, Drenger B, Levin PD, Kadari A, Gozal Y. A pediatric sedation/anesthesia program with dedicated care by anesthesiologists and nurses for procedures outside the operating room. J Pediatr. 2004;145:47-52.
14. Usher AG, Kearney RA, Tsui BCH. Propofol total intravenous anesthesia for MRI in children. Paediatr Anaesth. 2005;15:23-8.
15. Demir G, Cukurova Z, Eren G, Tekdos Y, Hergunsel O. The effect of "multiphase sedation" in the course of computed tomography and magnetic resonance imaging on children, parents and anesthesiologists. Rev Bras Anestesiol. 2012;62:511-9.
16. Griffiths MA, Kamat PP, McCracken CE, Simon HK. Is procedural sedation with propofol acceptable for complex imaging? A comparison of short vs. prolonged sedations in children. Pediatr Radiol. 2013;43:1273-8.
17. Zielinska M, Bartkowska-Sniatkowska A, Becke K, Höhne C, Najafi N, Schaffrath E et al. Safe pediatric procedural sedation and analgesia by anesthesiologists for elective procedures: a clinical practice statement from the european society for paediatric anaesthesiology. Paediatr Anaesth. 2019;29:583-90.
18. Cote CJ, Wilson S. Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures. Pediatr Dent. 2019;41:259-6

APA	özen ö, Uzumcugil F, Ankay Yilbas A, Akca B, Karagoz A (2022). Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients. , 1455 - 1462. 10.17826/cumj.1125733
Chicago	özen özge,Uzumcugil Filiz,Ankay Yilbas Aysun,Akca Basak,Karagoz Ayse Heves Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients. (2022): 1455 - 1462. 10.17826/cumj.1125733
MLA	özen özge,Uzumcugil Filiz,Ankay Yilbas Aysun,Akca Basak,Karagoz Ayse Heves Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients. , 2022, ss.1455 - 1462. 10.17826/cumj.1125733
AMA	özen ö,Uzumcugil F,Ankay Yilbas A,Akca B,Karagoz A Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients. . 2022; 1455 - 1462. 10.17826/cumj.1125733
Vancouver	özen ö,Uzumcugil F,Ankay Yilbas A,Akca B,Karagoz A Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients. . 2022; 1455 - 1462. 10.17826/cumj.1125733
IEEE	özen ö,Uzumcugil F,Ankay Yilbas A,Akca B,Karagoz A "Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients." , ss.1455 - 1462, 2022. 10.17826/cumj.1125733
ISNAD	özen, özge vd. "Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients". (2022), 1455-1462. https://doi.org/10.17826/cumj.1125733

APA	özen ö, Uzumcugil F, Ankay Yilbas A, Akca B, Karagoz A (2022). Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients. Cukurova Medical Journal, 47(4), 1455 - 1462. 10.17826/cumj.1125733
Chicago	özen özge,Uzumcugil Filiz,Ankay Yilbas Aysun,Akca Basak,Karagoz Ayse Heves Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients. Cukurova Medical Journal 47, no.4 (2022): 1455 - 1462. 10.17826/cumj.1125733
MLA	özen özge,Uzumcugil Filiz,Ankay Yilbas Aysun,Akca Basak,Karagoz Ayse Heves Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients. Cukurova Medical Journal, vol.47, no.4, 2022, ss.1455 - 1462. 10.17826/cumj.1125733
AMA	özen ö,Uzumcugil F,Ankay Yilbas A,Akca B,Karagoz A Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients. Cukurova Medical Journal. 2022; 47(4): 1455 - 1462. 10.17826/cumj.1125733
Vancouver	özen ö,Uzumcugil F,Ankay Yilbas A,Akca B,Karagoz A Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients. Cukurova Medical Journal. 2022; 47(4): 1455 - 1462. 10.17826/cumj.1125733
IEEE	özen ö,Uzumcugil F,Ankay Yilbas A,Akca B,Karagoz A "Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients." Cukurova Medical Journal, 47, ss.1455 - 1462, 2022. 10.17826/cumj.1125733
ISNAD	özen, özge vd. "Incidence of complications in anesthesia applications during magnetic resonance imaging in pediatric patients". Cukurova Medical Journal 47/4 (2022), 1455-1462. https://doi.org/10.17826/cumj.1125733