A 7-year-old child requires repeated MRI sessions under sedation for brain tumour follow-up. Which inhalational induction agent is appropriate for children in remote locations (MRI suite) and which ferromagnetic risk must be anticipated?

• A Halothane by face mask; no ferromagnetic risk as it is a gas
• B Propofol intravenous induction; no special equipment concerns in MRI suite
• C Sevoflurane via MRI-compatible anaesthesia machine; all ferrous equipment must be excluded from the magnetic field zone ✓
• D Ketamine intramuscular injection; no monitoring needed if patient is calm

Explanation

Sevoflurane is the preferred inhalational induction agent in children (pleasant odour, rapid onset, non-irritant, rapid recovery), and is appropriate for remote-site use. In MRI suites, all ferromagnetic equipment including standard laryngoscopes, oxygen cylinders, metal IV poles, and conventional monitoring cables are hazardous within the magnetic field — they can become high-speed projectiles or cause image artefacts. MRI-compatible (MR-conditional) anaesthesia machines, fibre-optic laryngoscopes, and MRI-compatible monitoring cables are mandatory. Standard monitoring (SpO₂, EtCO₂, NIBP, ECG with MRI-compatible electrodes) must be maintained throughout.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.