MRE Protocol

University of Oklahoma Children’s Hospital MRE Protocol for Pediatric Patients Requiring Anesthesia

Patient Qualifications for Scheduling:

Requires serial scans or has a contraindication for initial scan being a CTE – otherwise initial diagnostic scan should be a CTE

Age 10 or younger or has failed an awake attempt at MRE

MRE ordered by an Attending Pediatric Gastroenterologist or a Pediatric General Surgeon

Anesthesia Protocol for MRE with Breeza (clear oral contrast):

1. Patient arrives appropriately NPO (2 hrs clears, 4 hrs breastmilk, 6 hrs milk/formula, 8 hrs food)

2. Patient drinks 10mL/Kg of Breeza oral contrast

3. Awake IV placement for RSI per anesthesiologist discretion vs. plan for inhalational induction

4. 2 hours after patient finishes drinking patient is brought to MRI scanner and anesthesia is induced per attending anesthesiologist’s discretion

5. Intubation with cuffed ETT with plans for breath holding throughout scan

6. MRI started

7. IV contrast given by MRI RN per MRI protocol

8. Patient awakened and extubated per attending anesthesiologist’s discretion

9. OGT may be placed and suctioned and patient may be fully awakened per anesthesiologist discretion

10. Transfer to PACU

*Patient qualifications approved at multi-disciplinary meeting 3/15/18 – Dr. Lawrence (Radiology), Dr. Palle and Dr. Tung (GI), Dr. Duncan-Azadi (Anesthesiology), and Troy Nelson and Talina Kendrick (MRI)*

*Anesthesia protocol updated 8/13/18 for new oral contrast – “Breeza”*

References:

1. Mollard BJ, Smith EA, Lai ME, Phan T, Chistensen RE, Dillman JR. MR Enterography under the age of 10: a single institutional experience. Pediatr Radiol (2016) 46:43-49

2. Ngamprasertwong P, Mahmoud M. Letter to the Editor: Anesthesia for MRI Enterography in Children. J Clin Ane. (2014) 26;3:249