title: Efficacy and safety of deep sedation by non-anesthesiologists for cardiac MRI in children.
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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Division of Emergency Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.
authors.forename: Rini
authors.initials: R
authors.lastname: Jain
authors.forename: Toni
authors.initials: T
authors.lastname: Petrillo-Albarano
authors.forename: W James
authors.initials: WJ
authors.lastname: Parks
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Linzer
authors.forename: Jana A
authors.initials: JA
authors.lastname: Stockwell
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D054810:Deep Sedation / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006331:Heart Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D019028:Magnetic Resonance Imaging, Cine / Q000706:statistics & numerical data*; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D013315:Stress, Psychological / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D006993:Hypnotics and Sedatives