Münkler Paula, Attanasio Philipp, Parwani Abdul Shokor, Huemer Martin, Boldt Leif-Hendrik, Haverkamp Wilhelm, Wutzler Alexander
University Heart Center, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Germany.
Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.
Pacing Clin Electrophysiol. 2017 May;40(5):585-590. doi: 10.1111/pace.13063. Epub 2017 Apr 25.
Patients' satisfaction with invasive procedures largely relies on periprocedural perception of pain and discomfort. The necessity for intraprocedural sedation during catheter ablation of cardiac arrhythmias for technical reasons is widely accepted, but data on patients' experience of pain and satisfaction with the procedural sedation are scarce. We have assessed patients' pain and discomfort during and after the procedure using a standardized questionnaire.
One hundred seventeen patients who underwent catheter ablation answered a standardized questionnaire on periprocedural perception of pain and discomfort after different anesthetic protocols with propofol/midazolam with and without additional piritramide and ketamine/midazolam.
Patients report a high level of satisfaction with periprocedural sedation with 83% judging sedation as good or very good. The majority of patients was unconscious of the whole procedure and did not recollect experiencing pain. Procedural pain was reported by 7.7% of the patients and 16% reported adverse effects, e.g., postprocedural nausea and episodes of headache.
The results of our study show that deep sedation during catheter ablation of cardiac arrhythmias is generally well tolerated and patients are satisfied with the procedure. Yet, a number of patients reports pain or adverse events. Therefore, studies comparing different sedation strategies should be conducted in order to optimize sedation and analgesia.
患者对侵入性操作的满意度很大程度上取决于围手术期对疼痛和不适的感知。由于技术原因,在心律失常导管消融术中进行术中镇静的必要性已被广泛接受,但关于患者对术中疼痛的体验以及对术中镇静的满意度的数据却很少。我们使用标准化问卷评估了患者在手术期间和术后的疼痛和不适情况。
117例接受导管消融术的患者在使用丙泊酚/咪达唑仑(有或没有额外的匹拉米洞和氯胺酮/咪达唑仑)的不同麻醉方案后,回答了一份关于围手术期疼痛和不适感知的标准化问卷。
患者对围手术期镇静的满意度较高,83%的患者认为镇静效果良好或非常好。大多数患者对整个手术没有意识,也不记得经历过疼痛。7.7%的患者报告了术中疼痛,16%的患者报告了不良反应,如术后恶心和头痛发作。
我们的研究结果表明,心律失常导管消融术中的深度镇静通常耐受性良好,患者对该手术感到满意。然而,仍有一些患者报告了疼痛或不良事件。因此,应该进行比较不同镇静策略的研究,以优化镇静和镇痛效果。