Journal Article

22. Miscellanea

D. De Cosmo, M. Tedesco, A. Vardanega and R. De Stefani

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 7, issue s3, pages S36-S36
Published in print October 2005 | ISSN: 1099-5129
Published online October 2005 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1016/j.eupc.2005.08.238
22. Miscellanea

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The ablation of atrial fibrillation requires mild sedation and good analgesia, but the patient needs to be responsive to the verbal call and cooperative with the operator modulating the respiratory acts allowing an easier positioning of endocardiac catheters. This study was designed to evaluate the efficacy of remifentanil. The drug was infused via syringe driver, targeting the concentration at the site effect using a dedicated software (Stelpump®), and evaluating the depth of sedation, the efficacy of analgesia, the hemodynamic stability, the collateral effects, the patient's comfort and willingness to repeat the procedure and finally the operator's satisfaction. We enrolled 40 patients and started infusion at the initial effect-site concentration of 1.5 ng/ml. Pain was assessed with a 10-points visual analogue scale (VAS), where < 4 was considered an adequate analgesia. Sedation was determined with a 5- degree Observer's Assessment of Alertness/Sedation Scale (OAA/S). All 40 patients were in good analgesia, conscious sedation, mild comfort and hemodynamic stability; the target-site effect of remifentanil ranged between 1.5 and 2.5 μg/ml. Few patients had minor collateral effects and the operator satisfaction was good.

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Subjects: Cardiovascular Medicine

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