H. Volkan ACAR, Hale Yarkan UYSAL, Solmaz Günal ERUYAR, Bayazıt DİKMEN

Genel anestezi altında kraniyal manyetik rezonans görüntüleme işlemi uygulanan pediatrik hastalardaki ısı değişiklikleri

Amaç: Son yıllarda yapıları bazı çalışmalarda, anestezi/sedasyon altında manyetik rezonans görüntüleme işlemi yapılan pediatrik hastalarda vücut ısısında anlamlı artışlar olduğu bildirilmiştir. Bu nedenle, bu çalışmadaki amacımız genel anestezi altında kraniyal/orbital manyetik rezonans görüntüleme işlemi uygulanan pediatrik hastalaıdaki ısı değişikliklerini incelemektir. Yöntem: Çalışmaya genel anestezi altında manyetik rezonans görüntüleme işlemi uygulanacak 0-7 yaşları arasındaki 30 hasla dahil edildi. Anestezi indiiksiyonu. yüz maskesi yoluyla sevofluran inhalasyonuyla sağlandı. Daha sonra damar yolu açıldı ve anestezi idamesi sevofluran ile sağlandı. Kafa sargısı (coil) lakı İmadan hemen önce sağ kulaktan yapılan timpani k ısı ölçümü, MRG işlemi sona erip kafa sargısı çıkarıldıktan hemen sonra aynı kulaktan tekrarlandı. Bulgular: Hastalarımızın yaş ortalaması 19,3 ay idi. İşlem öncesi ve sonrası ısılar karşılaştırıldığında vücut ısısının 0.4 °C azaldığı saplandı (

Evaluation of temperature changes in pediatric patients undergoing magnetic resonance imaging under general anesthesia

Objective: Recent studies has reported significant increases in body temperature in pediatric patients undergoing magnetic resonance imaging under anesthesia/sedation. Therefore, our aim is to evaluate body temperature changes in pediatric patients undergoing cranial/orbital magnetic resonance imaging under general anesthesia. Method: Thirty patients aged 0-7 and undergoing magnetic resonance imaging under general anesthesia were included to the study. Induction of anesthesia was maintained with sevoflurane inhalation by facemask. After iv route was established, anesthesia was maintained with sevoflurane. Monitoring of tympanic temperature, which was done in right ear before applying head coil was repeated after removing head coil at the end of scanning. Results: Mean age of patients was 19.3 months. Body temperature was detected as decreased 0.4 °C, when pre-scan and post-scan temperatures were compared (<0.001). Body temperature was decreased in 21 patients (70.0%), was increased in 8 (26.7%), and showed no change in 1 patient (3.3%) in the study. Increase was not above 1 °C in any patient whose body temperatures were increased. When patients whose body temperatures were decreased or showed no change were compared with patients whose body temperatures were increased, mean age of patients with increases were detected as lower than the others (p=0.008). Conclusion: Body temperature was decreased in pediatric patients undergoing magnetic resonance imaging under general anesthesia. However, it should not be forgetten that body temperatures can be increased in these patients, too.

PDF

___

1. Waclitel RE. Dexter F. Dow AJ. Growth rates in pediatric diagnostic imaging and sedation. Anesth Analg 2009; 108(5): 1616-21.
2. Shellock FG. Radiofrequency energy-induced heating during MR procedures: a review. J Magn Reson Imaging 2000:12(1 ):30-6.
3. Rodriguez AO. Principles ol magnetic resonance imaging. Rev Mex Fis 2004:50(3):272-86.
4. Schaefer DJ. Safety aspects of radiofrequency power deposition in magnetic resonance. Magn Reson Imaging Clin N Am 1998; 6(4):775-89.
5. Shellock FG. Crues JV. MR procedures: Biologic effects, safety, and patient care. Radiology 2004:232(3):635-52.
6. Shellock FG, Rothman B, Sarti D. Healing of the scrotum by high-field-strength MR imaging. AJR Am J Roentgenol 1990: 154(6): 1229-32.
7. Shellock FG. Schatz CJ. Increased corneal temperature caused by MR imaging of the eye with a dedicated local coil. Radiology l992;185(3):697-9.
8. Kangarlu A. Shellock FG, Chakeres DW. 8.0-Tesia human MR system: Temperature changes associated with radiofrequency-induced heating of a head phantom. J Magn Reson Imaging 2003;l7(2):220-6.
9. Shuman WP. Haynor DR. Guy AW. Wesbey GE, Schaefer DJ, Moss AA. Superficial- and deep-tissue temperature increases in anesthetized dogs during exposure to high specific absorbtion rates in a 1.5-TMR imager. Radiology 1988;167(2):551-4.
10. Kussman BD, Mulkem RV. Holzman RS. Iatrogenic hyperthermia during cardiac magnetic resonance imaging. Anesth Analg 2004;99(4): 1053-5.
11. Bryan YF, Templeton TW, Nick TG, Szafran M. Tung A. Brain magnetic resonance imaging increases core body temperature in sedated children. Anesth Analg 2006; 102(6): 1674-9.
12. Machata AM. Willschke H. Kabon B. Prayer D. Marhofer P. Effect of brain magnetic resonance imaging on body core temperature in sedated infants and children. Br J Anaesth 2009;l()2(3):385-9.
13. Tsui BC. Wagner A, Usher AG, Cave DA. Tang C. Combined propofol and remifentanil intravenous anesthesia for pediatric patients undergoing magnetic resonance imaging. Pediatr Anaesth 2005:15(5):397-401.
14. Patel A. Davidson M. Aziz R, Taylor T. Pediatric temperature variation in the MR1 scanner under general anesthesia. Pediatric Anesthesia 2011.S090.
15. Isaacson DL. Yanosky DJ. Jones RA. Dennehy N. Spandorfer P. Baxter AL. Effect of MR1 strength and propofol sedation on pediatric core temperature change. J Magn Reson Imaging 201l:33(4):950-6.
16. Sharkey I. Boddy AV. Wallace H. Mycroft J. Hollis R. Picton S. Body surface area estimation in children using weight alone: application in paediatric oncology. Br J Cancer 2001:85( I ):23-8.
17. Sessler Dl. Mild perioperative hypothermia. N Engl J Med 1997: 336(24): 1730-7.
18. Sessler DL Perioperative heat balance. Anesthesiology 2000; 92(2): 578-96.
19. Cote CJ. Pediatric anesthesia. In: Miller RD. (ed.) Miller's Anesthesia. Philadelphia. Churchill Livingstone Elsevier 2010; 2559-97.
20. Macario A. Dexter F. What are the most important risk factors for a patient's developing intraoperative hypothermia? Anesth Analg 2002;94(1):215-20.
21. Dempsey MF. Condon B. Thermal injuries associated with MRI. Clin Radiol 200l;56(6): 457-65.
22. Nakamura T. Fukuda K. Hayakawa K. et al. Mechanism of bum injury during magnetic resonance imaging (MRI)-simple loops can induce heat injury. Front Med Biol Eng 2001; 11 (2): 117-29.
23. Eising EG. Hughes J. Nolle F. Jentzen W, Bockisch A. Bum injury by nuclear magnetic resonance imaging. Clin Imaging 2010; 34(4):293-7.
24. Eger EI. Brain magnetic resonance imaging increases core body temperature in sedated children. Anesth Analg 2007; 105( I ):283.
25. Independent expert group on mobile phones 1.2000. Mobile phones and health (http://www.iegmp.org.uk/report/index.htm)
26. van Rongen E. Roubos EW. van Aemsbergen LM ve ark. Mobile phones and children: Is precaution warranted? Bioelectromagnetics 2004:25(2): 142-4.
27. Peyman A. Rezazadeh AA. Gabriel C. Changes in the dielectric properties of rat tissue as a function of age at microwave frequencies. Phys Med Biol 2001:46(6): 1617-29.
28. El-Radhi AS, Barry W. Thermometry in paediatric practice. Arch Dis Child 2006:91(4):351-6.
29. Practice advisory on anesthetic care for magnetic resonance imaging: a report by the Society of Anesthesiologists Task Force on Anesthetic Care for Magnetic Resonance Imaging. Anesthesiology 2009:110(3):459-79.