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Effect of Laryngeal Mask Airway on Image Quality in Pediatric Patients Undergoing Brain Magnetic Resonance Imaging: A
Mohamed A Wadod1, Omnia Mohammed Aboelazm2, Mai Mohammed El Rawas1
1ICU and Pain Relief, National Cancer Institute, Cairo University, Cairo, Egypt.
Background:
Magnetic resonance imaging (MRI) is highly sensitive to motion, resulting in artifacts and lowering image quality. Laryngeal mask airway (LMA) provides numerous advantages over endotracheal tubes as it reduces laryngospasm, coughing, and the risk of postoperative desaturation.
Objectives:
We aimed to compare LMA with oral airway for airway management during brain MRI in terms of reducing motion artifacts, which can improve image quality.
Methods:
This randomized, controlled, double-blind trial was carried out on 40 pediatrics aged 1 - 18 years, American Society of Anesthesiologists (ASA) physical status І and П undergoing brain MRI. Patients were randomized into two equal groups according to the airway method, the control (Guedel oral airway) group and the LMA group. A compatible anesthesia machine was used to provide O2 and sevoflurane 2% - 4%.
Results:
The mean MRI image quality score was significantly higher in the LMA group than in the control group (26.10 ± 3.97 versus 18.60 ± 5.30, P < 0.001). Mean arterial blood pressure and heart rate were significantly lower in the LMA group than in the control group at all study times except at baseline and immediate post-extubation (P < 0.05). Cough was significantly lower in LMA than in the control group (15% vs. 50%, P = 0.040). Airway complications (sore throat, laryngeal spasm, and bronchospasm), nausea, and vomiting did not have a significantly different between the two groups.
Conclusions:
Compared to Guedel oral airway, using LMA for airway management in pediatrics undergoing MRI scans improved the image quality with less cough and better hemodynamics.
Insights
Laryngeal mask airway (LMA) use during pediatric brain MRI significantly improves image quality and reduces motion artifacts compared to oral airways. LMA also led to less coughing and better hemodynamic stability in pediatric patients.
Area of Science:
- Anesthesiology
- Radiology
- Pediatric Imaging
Background:
- Magnetic resonance imaging (MRI) is susceptible to motion artifacts, degrading image quality.
- Laryngeal mask airway (LMA) offers advantages over endotracheal tubes, reducing complications like laryngospasm and coughing.
- Effective airway management is crucial for high-quality brain MRI in pediatric patients.
Purpose of the Study:
- To compare the efficacy of LMA versus oral airway for airway management during pediatric brain MRI.
- To evaluate the impact of airway management on reducing motion artifacts and improving MRI image quality.
- To assess hemodynamic stability and incidence of cough in pediatric patients undergoing brain MRI with different airway devices.
Main Methods:
- A randomized, double-blind, controlled trial involving 40 pediatric patients (1-18 years, ASA I-II) undergoing brain MRI.
- Patients were randomized into two groups: Guedel oral airway (control) and LMA.
- Anesthesia was maintained with sevoflurane and oxygen using a compatible anesthesia machine.
Main Results:
- The LMA group demonstrated significantly higher MRI image quality scores (26.10 ± 3.97) compared to the oral airway group (18.60 ± 5.30; P < 0.001).
- Mean arterial pressure and heart rate were significantly lower in the LMA group post-procedure (P < 0.05).
- Cough incidence was significantly reduced in the LMA group (15%) versus the oral airway group (50%; P = 0.040).
Conclusions:
- LMA is superior to oral airway for airway management in pediatric patients undergoing brain MRI.
- LMA use results in improved MRI image quality, reduced cough, and better hemodynamic control.
- LMA provides a safe and effective airway management strategy for pediatric brain MRI procedures.
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