Pediatric anesthesia for magnetic resonance scan with a laryngeal mask: maintenance in case of reduced intracranial compliance

Introduction

The aim of the study is to evaluate three different methods in order to carry out a magnetic resonance brain scan in children.

Materials and methods

In our study we analyzed 90 ASA I–II, nonpremedicated, children divided into three groups of 30 patients (A, B, C). We used for all of them the laryngeal mask [1], inhalatory induction for all three groups and three different kinds of maintenance: inhalatory maintenance, intravenous maintenance and maintenance with balanced anesthesia. The 30 'A' children (age 5.9 ± 4.8 years) underwent inhalatory anesthesia with sevoflurane (1.2 MAC) in spontaneous breathing for induction and maintenance. The 30 'B' children (age 5.9 ± 3 years) underwent inhalatory anesthesia with sevoflurane (1.2 MAC) for induction and endovenous anesthesia with propofol for maintenance [2]. In the 30 'C' children (age 5.1 ± 4.6 years) we used inhalatory anesthesia with sevoflurane (1.2 MAC) for induction and balanced anesthesia for maintenance [2].

Discussion

We demonstrated that the discharge time using an inhalatory maintenance in spontaneous breathing was shorter than using a maintenance with intravenous propofol anesthesia. One of the halogenates' side effects is the increase of cerebral blood flow. In patients with a reduced intracranic compliance (e.g. brain tumors) a maintenance with a balanced general anesthesia with sevoflurane and propofol could be more appropriate (group C).

Conclusions

In all three groups we did not find any significant side effects. In conclusion, we can positively confirm the synergy of both inhalatory and intravenous techniques, joining the advantage of general balanced anesthesia for the patients with a reduced intracranial compliance.