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.
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.
Authors: Eugénie Marie-Christine Riesenkampff; Boris Schmitt; Bernhard Schnackenburg; Michael Huebler; Vladimir Alexi-Meskishvili; Roland Hetzer; Felix Berger; Titus Kuehne Journal: Pediatr Cardiol Date: 2009-01-30 Impact factor: 1.655
Authors: Mark A Fogel; Paul M Weinberg; Elicia Parave; Christine Harris; Lisa Montenegro; Matthew A Harris; Mikael Concepcion Journal: J Pediatr Date: 2007-11-05 Impact factor: 4.406
Authors: J M Lieberman; R J Alfidi; A D Nelson; R E Botti; T W Moir; J R Haaga; S Kopiwoda; F D Miraldi; A M Cohen; H E Butler Journal: Radiology Date: 1984-08 Impact factor: 11.105
Authors: Kalpesh N Patel; Harold K Simon; Christina A Stockwell; Jana A Stockwell; Michael A DeGuzman; Pei-Ling Roerig; Mark R Rigby Journal: Pediatr Emerg Care Date: 2009-03 Impact factor: 1.454
Authors: Kirsten C Odegard; James A DiNardo; Beverly Tsai-Goodman; Andrew J Powell; Tal Geva; Peter C Laussen Journal: Paediatr Anaesth Date: 2004-06 Impact factor: 2.556
Authors: Frances C Lee; Karen Queliza; Bruno P Chumpitazi; Amber P Rogers; Catherine Seipel; Douglas S Fishman Journal: Front Pediatr Date: 2021-02-02 Impact factor: 3.418