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    ASA Issues Practice Advisory on Anesthetic Care for MRI

    By Jennifer Huddleston, staff writer     

    The American Society of Anesthesiologists (ASA) recently issued a practice advisory on anesthetic care for magnetic resonance imaging (MRI).

    According to the practice advisory’s creators, The ASA Task Force on Anesthetic Care for MRI, the MRI suite can be a dangerous area because of the presence of several energy sources, including a strong static magnetic field, radiofrequency waves and a pulsed magnetic field.

    In the practice advisory, anesthetic care within the MRI suite is defined as general anesthesia, moderate and deep sedation, monitored anesthesia care, critical care support and ventilatory support.

    The 13-member task force created the practice advisory in an attempt to increase patient and staff safety, prevent accidental injuries, identify potential health and equipment-related hazards, discover limitations of physiologic monitoring capabilities and reduce adverse outcomes associated with MRI.

    The task force was comprised of 10 anesthesiologists from private and academic practices across the U.S., one radiologist and two consulting methodologists from the ASA Committee on Standards and Practice Parameters.

    Among the recommendations included in the practice advisory are:

    • Anesthesiologists should be educated about the potential health hazards associated with the MRI environment, including which items and implantable devices should not be brought into certain areas of the suite or should be treated with caution.
    • Anesthesiologists should communicate with each patient, the referring physician and the radiologist to determine whether the patient has a high-risk medical condition, requires equipment during imaging or has implanted devices or items.
    • Anesthesiologists should collaborate with support staff to create a plan that addresses the requirements of the scan and personnel needs, the positioning of equipment, the anesthesiologist and the patient, special requirements or unique issues and plans for emergency situations.
    • Anesthesiologists should follow the ASA Standards for Basic Anesthetic Monitoring when monitoring MRI patients.
    • Anesthesiologists should collaborate with the radiologist and other staff in providing post-anesthetic care for the patient.
    • Anesthesiologists should collaborate with their facilities to identify and label which anesthesia-related equipment is safe or unsafe for each MRI scanner.

    In the practice advisory, the task force notes its belief that pacemakers and implantable cardioverter-defibrillators pose a potentially fatal hazard and that patients with those devices should not undergo MRI.

    For more information on anesthetic care for MRI, the full practice advisory can be found in the March 2009 issue of Anesthesiology.

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