Anaesthetic management of a young boy with a large exophytic mass undergoing MRI-A case report

Abstract

The difficulties associated with non-operating room anaesthesia (NORA) include an unfamiliar setting, lack of specialized staff and limited equipment. We present anaesthetic care of a 16-year-old boy with a massive, exophytic lump in his left sacral area, posted for MRI under general anaesthesia. This patient had anaemia, low albumin levels, and anticipated difficult airway due to the lump’s size, which stopped him from lying supine. We ensured he was pain free and were prepared for possible hypotensive episodes during the procedure. Airway was secured with a supraglottic airway, I-gel inserted in lateral position, used muscle relaxants for clear images, and used vasopressors when he had hemodynamic instability. The MRI was uneventful, and was consistent with findings of metastatic melanoma. This case teaches us how vital planning and quick thinking are crucial in NORA for such complicated patients.