Propofol drip infusion anesthesia for MRI scanning: two case reports

Area of Science:

• Anesthesiology
• Medical Imaging
• Oral and Maxillofacial Surgery

Background:

• Magnetic Resonance Imaging (MRI) environments pose unique challenges for standard anesthesia equipment due to intense magnetic fields.
• Oral and maxillofacial surgery often requires high-quality imaging, necessitating patient immobilization during MRI scans.

Observation:

• Two pediatric cases (15-year-old with developmental disability, 5-year-old healthy) undergoing oral maxillofacial surgery MRI were managed with general anesthesia.
• Anesthesia was initiated in the MRI room, involving endotracheal intubation and total intravenous anesthesia with propofol.
• Physiologic monitoring adapted to the MRI environment, using standard monitors during pauses and specialized equipment during scanning.

Findings:

• Total intravenous anesthesia with propofol infusion (4-7 mg/kg/h) provided adequate anesthesia and airway control.
• General anesthesia facilitated complete patient immobilization, crucial for obtaining diagnostic-quality MRI images.

Implications:

• General anesthesia is recommended over sedation for pediatric oral and maxillofacial surgery patients undergoing MRI, particularly those with disabilities or of pre-cooperative age.
• This approach ensures airway security and patient cooperation, leading to improved diagnostic accuracy in complex surgical cases.