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

Autor: Jain R; Department of Pediatrics, Division of Emergency Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada., Petrillo-Albarano T, Parks WJ, Linzer JF Sr, Stockwell JA
Jazyk: angličtina
Zdroj: Pediatric radiology [Pediatr Radiol] 2013 Mar; Vol. 43 (5), pp. 605-11. Date of Electronic Publication: 2012 Nov 25.
DOI: 10.1007/s00247-012-2566-0
Abstrakt: 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.
Databáze: MEDLINE
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