A Case of General Anaesthesia Using an I-gel Airway for MRI of an Adult Patient With Athetoid Cerebral Palsy

Patients with athetoid cerebral palsy may develop cervical myelopathy owing to repetitive involuntary motion. In these patients, MRI evaluation is required; involuntary motion is problematic, and general anaesthesia and immobilisation may be necessary. However, MRI studies requiring muscle relaxation and general anesthesia in adults are rare. A 65-year-old man with a history of athetoid cerebral palsy required an MRI of the cervical spine under general anaesthesia. General anaesthesia was administered with 5 mg of midazolam and 50 mg of rocuronium in a room adjacent to the MRI room. The airway was secured using an i-gel airway, and the patient was ventilated using a Jackson-Rees circuit. As the only MRI-compatible monitoring method available at our institution was SpO monitoring, blood pressure was monitored by palpation of the dorsal pedal artery, and ventilation was monitored visually by an anaesthesiologist in the MRI room. The MRI was uneventful. After scanning, the patient awoke promptly and was returned to the ward. An MRI scan under general anaesthesia requires monitoring of the patient, securing of the airway and ventilation, and careful selection of suitable anaesthetic agents. Although MRI scans requiring general anaesthesia are rare, anaesthesiologists should be prepared for this eventuality.