Pediatric Radiology

, Volume 43, Issue 5, pp 605–611

Efficacy and safety of deep sedation by non-anesthesiologists for cardiac MRI in children

  • Rini Jain
  • Toni Petrillo-Albarano
  • W. James Parks
  • Jeffrey F. LinzerSr.
  • Jana A. Stockwell
Original Article

Abstract

Background

Cardiac MRI has become widespread to characterize cardiac lesions in children. No study has examined the role of deep sedation performed by non-anesthesiologists for this investigation.

Objective

We hypothesized that deep sedation provided by non-anesthesiologists can be provided with a similar safety and efficacy profile to general anesthesia provided by anesthesiologists.

Materials and methods

This is a retrospective chart review of children who underwent cardiac MRI over a 5-year period. The following data were collected from the medical records: demographic data, cardiac lesion, American Society of Anesthesiologists (ASA) physical status, sedation type, provider, medications, sedation duration and adverse events or interventions. Image and sedation adequacy were recorded.

Results

Of 1,465 studies identified, 1,197 met inclusion criteria; 43 studies (3.6%) used general anesthesia, 506 (42.3%) had deep sedation and eight (0.7%) required anxiolysis only. The remaining 640 studies (53.5%) were performed without sedation. There were two complications in the general anesthesia group (4.7%) versus 17 in the deep sedation group (3.4%). Sedation was considered inadequate in 22 of the 506 deep sedation patients (4.3%). Adequate images were obtained in 95.3% of general anesthesia patients versus 86.6% of deep sedation patients.

Conclusion

There was no difference in the incidence of adverse events or cardiac MRI image adequacy for children receiving general anesthesia by anesthesiologists versus deep sedation by non-anesthesiologists. In summary, this study demonstrates that an appropriately trained sedation provider can provide deep sedation for cardiac MRI without the need for general anesthesia in selected cases.

Keywords

Cardiac MRI Sedation Propofol Anesthesia 

Abbreviations

ASA

American Society of Anesthesiologists

CHOA

Children’s Healthcare of Atlanta

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Rini Jain
    • 1
  • Toni Petrillo-Albarano
    • 2
    • 3
  • W. James Parks
    • 4
  • Jeffrey F. LinzerSr.
    • 3
    • 5
  • Jana A. Stockwell
    • 2
    • 3
  1. 1.Department of Pediatrics, Division of Emergency Medicine, Children’s Hospital of Eastern OntarioUniversity of OttawaOttawaCanada
  2. 2.Department of Pediatrics, Division of Critical Care MedicineEmory University School of MedicineAtlantaUSA
  3. 3.Children’s Sedation Services, Children’s Healthcare of Atlanta at EglestonAtlantaUSA
  4. 4.Department of Pediatrics, Division of Cardiology, Children’s Healthcare of Atlanta, Sibley Heart CenterEmory University School of MedicineAtlantaUSA
  5. 5.Department of Pediatrics, Division of Emergency MedicineEmory University School of MedicineAtlantaUSA

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