Modality of anaesthetic care for pediatric MRI at the National Hospital of Nouakchott (Mauritania)

medecine

Summary Introduction: Magnetic resonance imaging (MRI) is a painless examination, lasting 30 to 60 minutes. To carry it out, the child is placed in a long and narrow tunnel where there is a lot of noise. MRI usually requires sedation or general anaesthesia in children. The aim of our study was to determine and analyze the modalities of anesthetic management for pediatric MRI at the Nouakchott hospital center (Mauritania). Material and method: We carried out a descriptive and retrospective study, which concerned the files of 230 pediatric patients collected at the radiology department (MRI unit) of the national hospital center of Nouakchott (Mauritania), during a period of two years (01 /09/2016 to 01/09/2018). Children requiring sedation or anaesthesia for MRI were included in the study. The pre-anesthetic consultation was systematic. Anaesthesia or sedation is performed exclusively by anesthesiologists. The main anaesthetic products used are halothane, propofol and ketamine. Results and comments: the average age was 47.5 months; the sex ratio was 1.95 in favor of men. Induction and maintenance were provided by halothane, propofol or ketamine. Halothane was used in 98%, compared to 2% for propofol and/or ketamine. The main indication for MRI was psychomotor delay (30% of cases). The majority (90%) of our patients were referred from a structure outside of CHN compared to 10% of patients referred by CHN services. Establishment of the peripheral venous line was found in 97% of patients. The use of premedication was the rule and only concerned half of the cases. Oxygen saturation monitoring and spontaneous ventilation were 100% assured. More than eighty-seven percent of our patients have an MRI exam time of between 30 and 40 minutes. Three incidents of awakening during the MRI examination, one delayed awakening and one episode of vomiting were reported. No deaths were reported during this study period. Conclusion: The study that we carried out made it possible to describe the modalities of the anaesthetic management of pediatric patients to be examined by magnetic resonance imaging at the national hospital center of Nouakchott (Mauritania). The involvement of anaesthetists demonstrates the importance given to this act which requires, among other things, special security. Recommendations concerning equipment compatible with electromagnetic fields and the introduction of new anaesthesia products must be the subject of new studies in this area.

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