Feasibility and Safety of Using Supraglottic Airway Devices for Pediatric Patients Undergoing Magnetic Resonance Imaging: A Case Series of High-Risk Patients.

Background: General anesthesia or sedation is commonly required for pediatric patients undergoing magnetic resonance imaging (MRI) scans, and airway management during the procedure is the highest concern for anesthesiologists owing to the limited access to the patient in the MRI unit. The use of supraglottic airway devices (SADs) has recently become more popular than endotracheal tubes; however, the feasibility of using SADs for children in MRI suites was reported only in a few studies that involved healthy patients.

Methods: We present a successful case series of 30 pediatric patients, and the majority are high-risk patients, including patients with aromatic L-amino acid decarboxylase (AADC) deficiency, mitochondrial disease, and tuberous sclerosis, using either i-gel or laryngeal masks for airway maintenance during MRI examination.

Results: A total of 38 MRI exams were conducted; the patients' median age was 4 (range 1.6-17.0 years), and the mean examination time was 50.87 minutes. No patient experienced oxygen desaturation, and only 1 patient with AADC deficiency had an episode of hypotension. The MRI scans were completed without interruption with an adequate image quality according to a specialized radiologist.

Conclusion: From the clinical point of view, this case series demonstrated a broader application of SADs for airway maintenance during MRI scans for pediatric patients with a high risk during anesthesia rather than only for a healthy patient population.