ORIGINAL ARTICLE Efficacy and safety of deep sedation by non-anesthesiologists for cardiac MRI in children Rini Jain & Toni Petrillo-Albarano & W. James Parks & Jeffrey F. Linzer Sr. & Jana A. Stockwell Received: 13 June 2012 / Revised: 12 October 2012 / Accepted: 15 October 2012 / Published online: 25 November 2012 # Springer-Verlag Berlin Heidelberg 2012 Abstract Background Cardiac MRI has become widespread to charac- terize 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 re- view of children who underwent cardiac MRI over a 5- year period. The following data were collected from the medical records: demographic data, cardiac lesion, Amer- ican 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 anx- iolysis only. The remaining 640 studies (53.5%) were per- formed 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 Introduction The characterization of cardiac tissues and cardiovascular lesions using MRI has become widespread during the last 20 years [1]. Electrocardiographic-gated cardiac MRI, along with other software advances and imaging techniques, have resulted in the advancement of a robust platform capable of allowing detailed assessment and evaluation of complex con- genital and acquired heart defects, including ventricular vol- ume quantification, ejection fractions, pressure gradients, R. Jain Department of Pediatrics, Division of Emergency Medicine, Children’ s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada T. Petrillo-Albarano : J. A. Stockwell Department of Pediatrics, Division of Critical Care Medicine, Emory University School of Medicine, Atlanta, GA, USA T. Petrillo-Albarano : J. F. Linzer Sr. : J. A. Stockwell (*) Children’ s Sedation Services, Children’ s Healthcare of Atlanta at Egleston, 1405 Clifton Road, NE, Atlanta, GA 30322, USA e-mail: jana.stockwell@choa.org W. J. Parks Department of Pediatrics, Division of Cardiology, Children’ s Healthcare of Atlanta, Sibley Heart Center, Emory University School of Medicine, Atlanta, GA, USA J. F. Linzer Sr. Department of Pediatrics, Division of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA Pediatr Radiol (2013) 43:605–611 DOI 10.1007/s00247-012-2566-0