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电生理与心脏起搏实验室中的深度镇静实践:由意大利心律失常与心脏起搏协会(AIAC)发起的一项意大利调查结果

The Practice of Deep Sedation in Electrophysiology and Cardiac Pacing Laboratories: Results of an Italian Survey Promoted by the AIAC (Italian Association of Arrhythmology and Cardiac Pacing).

作者信息

Palmisano Pietro, Ziacchi Matteo, Angeletti Andrea, Guerra Federico, Forleo Giovanni Battista, Bertini Matteo, Notarstefano Pasquale, Accogli Michele, Lavalle Carlo, Bisignani Giovanni, Landolina Maurizio, Zanotto Gabriele, D'Onofrio Antonio, Ricci Renato Pietro, De Ponti Roberto, Boriani Giuseppe

机构信息

Cardiology Unit, "Card. G. Panico" Hospital, 73039 Tricase, Italy.

Institute of Cardiology, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy.

出版信息

J Clin Med. 2021 Oct 28;10(21):5035. doi: 10.3390/jcm10215035.

Abstract

The aim of this survey, which was open to all Italian cardiologists involved in arrhythmia, was to assess common practice regarding sedation and analgesia in interventional electrophysiology procedures in Italy. The survey consisted of 28 questions regarding the approach to sedation used for elective direct-current cardioversion (DCC), subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation, atrial fibrillation (AF) ablation, ventricular tachycardia (VT) ablation, and transvenous lead extraction procedures. A total of 105 cardiologists from 92 Italian centres took part in the survey. The rate of centres where DCC, S-ICD implantation, AF ablation, VT ablation and lead extraction procedures were performed without anaesthesiologic assistance was 60.9%, 23.6%, 51.2%, 37.3%, and 66.7%, respectively. When these procedures were performed without anaesthesiologic assistance, the drugs (in addition to local anaesthetics) commonly administered were benzodiazepines (from 64.3% to 79.6%), opioids (from 74.4% to 88.1%), and general anaesthetics (from 7.1% to 30.4%). Twenty-three (21.9%) of the 105 cardiologists declared that they routinely administered propofol, without the supervision of an anaesthesiologist, in at least one of the above-mentioned procedures. In current Italian clinical practice, there is a lack of uniformity in the sedation/analgesia approach used in interventional electrophysiology procedures.

摘要

本次调查面向所有参与心律失常治疗的意大利心脏病专家,旨在评估意大利介入电生理手术中镇静和镇痛的常见做法。该调查包含28个问题,涉及用于择期直流电复律(DCC)、皮下植入式心律转复除颤器(S-ICD)植入、心房颤动(AF)消融、室性心动过速(VT)消融以及经静脉导线拔除术的镇静方法。来自意大利92个中心的105位心脏病专家参与了此次调查。在没有麻醉辅助的情况下进行DCC、S-ICD植入、AF消融、VT消融和导线拔除术的中心比例分别为60.9%、23.6%、51.2%、37.3%和66.7%。在没有麻醉辅助进行这些手术时,常用的药物(除局部麻醉药外)有苯二氮䓬类药物(64.3%至79.6%)、阿片类药物(74.4%至88.1%)以及全身麻醉药(7.1%至30.4%)。105位心脏病专家中有23位(21.9%)宣称,他们在上述至少一种手术中,在没有麻醉医生监督的情况下常规使用丙泊酚。在当前意大利的临床实践中,介入电生理手术所采用的镇静/镇痛方法缺乏统一性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e101/8584354/437268c83e17/jcm-10-05035-g001.jpg

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