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An unusual source of interference in the neuroradiology suite
- Umesh Goneppanavar, Fiona Maryann Patrao, Nanda Shetty (20 November 2007)
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Umesh Goneppanavar Assistant Professor, Anaesthesia, Fiona Maryann Patrao, Nanda Shetty
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An unusual source of interference in the neuroradiology suite Goneppanavar Umesh, M.D., Fiona Maryann Patrao, M.B.B.S., Nanda Shetty, M.D. Department of Anaesthesiology, Kasturba Medical College, Manipal – 576 104 Your article on anaesthetic concerns for neuroradiology1 was well written and we enjoyed reading it. We occasionally provide anaesthesia for interventional neuroradiological procedures at our institution. The article benefited us greatly in planning for some of the procedures for which we provided anaesthesia in the past few months. We would like to highlight that many of the diverse gadgets employed by our fraternity to monitor patients and to ensure their safety have radio-opaque components, which mandate that we make conscious effort to distance them from the image field. We wish to share here our experience of mechanical interference produced by equipment used for patient safety. An eighteen month old child was scheduled for embolisation of a spinal arteriovenous fistula located at T6-T11 level. General anaesthesia was induced after establishing non-invasive monitoring. Invasive blood pressure monitoring was secured in the right radial artery. To prevent hypothermia, the child’s head, upper limbs and lower limbs up to knees were covered with gamzee pads. We also used a heat and moisture exchanger, fluid warmer and a warming blanket (Thermamed Smartcare patient warming systems, Germany), which was placed over the child’s body. Care was taken to ensure that all radio-opaque material, especially the electrocardiogram wires and cables for the other monitors were kept outside the possible field of exposure. However, the first image revealed multiple (7-8) radio-opaque lines traveling across the length of the image. We could not find any cables on visual inspection. It was then that we realized the convective warming blanket was probably responsible for this problem. After removal of the warming blanket, we did not face any further problems. As stated in the article, hypothermia is an attendant risk in the neuroradiology suite, especially for the paediatric population. It is mandatory that all possible steps be taken to prevent the development of this complication. However, we should ensure that the measures we take in this regard do not interfere with the process of imaging as happened in our case. 1. Varma MK, Price K, Jayakrishnan V, Manickam B, Kessell G. Anaesthetic considerations for interventional neuroradiology. Br J Anaesth 2007; 99: 75-85 Conflict of Interest:None declared |
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