Feasibility and safety of using local anaesthesia with conscious sedation during complex cardiac implantable electronic device procedures

Abstract We assessed the feasibility and safety of using local anaesthesia with conscious sedation as an alternative to general anaesthesia during complex and noncomplex cardiac implantable device procedures. We enrolled 279 consecutive patients who underwent cardiac device implantation/replacement...

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Autores principales:	Elif Kaya, Hendrik Südkamp, Julia Lortz, Tienush Rassaf, Rolf Alexander Jánosi
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f30603e69dbc4445b852be4d0c8e0242
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spelling	oai:doaj.org-article:f30603e69dbc4445b852be4d0c8e02422021-12-02T12:31:56ZFeasibility and safety of using local anaesthesia with conscious sedation during complex cardiac implantable electronic device procedures10.1038/s41598-018-25457-x2045-2322https://doaj.org/article/f30603e69dbc4445b852be4d0c8e02422018-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-25457-xhttps://doaj.org/toc/2045-2322Abstract We assessed the feasibility and safety of using local anaesthesia with conscious sedation as an alternative to general anaesthesia during complex and noncomplex cardiac implantable device procedures. We enrolled 279 consecutive patients who underwent cardiac device implantation/replacement at our tertiary/quaternary cardiac specialist hospital during a 17-month study period. Continuous combined intravenous conscious sedation with propofol and midazolam plus fentanyl and local anaesthesia were used for all procedures. Among the patients, 113, 59, 43, and 64 patients underwent pacemaker implantation, implantable cardiac defibrillator implantation, cardiac resynchronisation therapy device implantation, and generator exchange, respectively. The procedural success rate was 100%, with no apnoea or hypoxia episodes requiring therapeutic intervention. None of the patients required conversion to general anaesthesia. The mean surgical duration was longer for complex vs. noncomplex procedures (p = 0.003). The minimum mean arterial pressure during complex procedures was slightly lower than that during noncomplex procedures (p = 0.03). The perioperative (<24 h) mortality rate was 0%, and neither complexity group required tracheal intubation. Only two patients (0.7%) required unplanned intensive care unit admission for further surveillance. Our findings suggest that local anaesthesia with conscious sedation is a safe and feasible option for cardiac device implantation procedures, including complex procedures.Elif KayaHendrik SüdkampJulia LortzTienush RassafRolf Alexander JánosiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-6 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Elif Kaya Hendrik Südkamp Julia Lortz Tienush Rassaf Rolf Alexander Jánosi Feasibility and safety of using local anaesthesia with conscious sedation during complex cardiac implantable electronic device procedures
description	Abstract We assessed the feasibility and safety of using local anaesthesia with conscious sedation as an alternative to general anaesthesia during complex and noncomplex cardiac implantable device procedures. We enrolled 279 consecutive patients who underwent cardiac device implantation/replacement at our tertiary/quaternary cardiac specialist hospital during a 17-month study period. Continuous combined intravenous conscious sedation with propofol and midazolam plus fentanyl and local anaesthesia were used for all procedures. Among the patients, 113, 59, 43, and 64 patients underwent pacemaker implantation, implantable cardiac defibrillator implantation, cardiac resynchronisation therapy device implantation, and generator exchange, respectively. The procedural success rate was 100%, with no apnoea or hypoxia episodes requiring therapeutic intervention. None of the patients required conversion to general anaesthesia. The mean surgical duration was longer for complex vs. noncomplex procedures (p = 0.003). The minimum mean arterial pressure during complex procedures was slightly lower than that during noncomplex procedures (p = 0.03). The perioperative (<24 h) mortality rate was 0%, and neither complexity group required tracheal intubation. Only two patients (0.7%) required unplanned intensive care unit admission for further surveillance. Our findings suggest that local anaesthesia with conscious sedation is a safe and feasible option for cardiac device implantation procedures, including complex procedures.
format	article
author	Elif Kaya Hendrik Südkamp Julia Lortz Tienush Rassaf Rolf Alexander Jánosi
author_facet	Elif Kaya Hendrik Südkamp Julia Lortz Tienush Rassaf Rolf Alexander Jánosi
author_sort	Elif Kaya
title	Feasibility and safety of using local anaesthesia with conscious sedation during complex cardiac implantable electronic device procedures
title_short	Feasibility and safety of using local anaesthesia with conscious sedation during complex cardiac implantable electronic device procedures
title_full	Feasibility and safety of using local anaesthesia with conscious sedation during complex cardiac implantable electronic device procedures
title_fullStr	Feasibility and safety of using local anaesthesia with conscious sedation during complex cardiac implantable electronic device procedures
title_full_unstemmed	Feasibility and safety of using local anaesthesia with conscious sedation during complex cardiac implantable electronic device procedures
title_sort	feasibility and safety of using local anaesthesia with conscious sedation during complex cardiac implantable electronic device procedures
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/f30603e69dbc4445b852be4d0c8e0242
work_keys_str_mv	AT elifkaya feasibilityandsafetyofusinglocalanaesthesiawithconscioussedationduringcomplexcardiacimplantableelectronicdeviceprocedures AT hendriksudkamp feasibilityandsafetyofusinglocalanaesthesiawithconscioussedationduringcomplexcardiacimplantableelectronicdeviceprocedures AT julialortz feasibilityandsafetyofusinglocalanaesthesiawithconscioussedationduringcomplexcardiacimplantableelectronicdeviceprocedures AT tienushrassaf feasibilityandsafetyofusinglocalanaesthesiawithconscioussedationduringcomplexcardiacimplantableelectronicdeviceprocedures AT rolfalexanderjanosi feasibilityandsafetyofusinglocalanaesthesiawithconscioussedationduringcomplexcardiacimplantableelectronicdeviceprocedures
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Feasibility and safety of using local anaesthesia with conscious sedation during complex cardiac implantable electronic device procedures

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