PATIENT CONTROLLED SEDATION DURING RADIOFREQUENCY ABLATION FOR SUPRAVENTRICULAR TACHYCARDIA
H.R. Weerasooriya*, J. Elson, M.J.E. Davis, A.C. Powell.
Cardiology Department, Royal Perth Hospital, Perth, Western Australia.
Sedation during catheter ablation procedures for supraventricular tachycardia (SVT) is an important consideration. The use of sedation during RF ablation procedures is very variable between patients and between institutions. We evaluated the safety and efficacy of a novel patient controlled delivery system using propofol as the sedating agent.
We prospectively studied 28 pts undergoing RF ablation for SVT at Royal Perth Hospital. Fifteen pts had operator controlled (OC) sedation using boluses of fentanyl and midazolam, and 13 pts had patient controlled (PC) sedation using boluses of propofol delivered via a novel locally designed mechanical delivery pump. Respiratory rate, sedation level, blood pressure and oxygen saturation were measured at fifteen minutely intervals in all patients.
The mean dose of propofol used in the PC group was 373±317mg (mean procedure duration = 148±54 mins) while on average, 99±75mcg of fentanyl and 4mg±2.5mg of midazolam were given in the OC group (mean procedure duration = 159±59 mins). In the PC group, no adverse events directly attributable to propofol, such as respiratory depression or haemodynamic compromise were seen. Subjective semiquantitative estimation of patient satisfaction and doctor and nurse evaluation of patient comfort and co-operation were not significantly different when PC sedation was compared to OC sedation.
Conclusion: This is the first description of patient controlled sedation during RF ablation procedures for SVT. Patient controlled sedation using propofol is a safe and effective alternative to operator delivered sedation.
