Feasibility of Anaesthetic Provision for Paediatric Patients Undergoing Off-Site Intraoperative MRI-Guided Neurosurgery: The Singapore Experience from 2009 to 2012
The benefits of using intraoperative magnetic resonance imaging (iMRI) for neurosurgery have been recognised. However, iMRI facilities are not available in all hospitals. For example, in Singapore iMRI is currently available only at the Singapore General Hospital, an adult hospital without facilities for intensive care management of patients less than 12 years of age. KK Women's and Children's Hospital is a dedicated children's hospital situated 6.3 km away from this facility. In order to obtain iMRI services for our paediatric patients, transport to Singapore General Hospital is required, with return to our hospital for postoperative management. Since July 2009 we have managed nine paediatric patients in this manner: three children with arteriovenous malformations and six children with brain tumours. There was no morbidity or mortality that could be attributed to the transport of patients either to or from Singapore General Hospital. Our experience suggests that with adequate planning and preparation, providing anaesthetic care and transporting children for off-site iMRI-guided neurosurgery is feasible and safe for selected children.
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