Unconscious Sedation with Propofol Versus Conscious Sedation with Pentothal for Catheter Ablation of Atrial Fibrillation

Abstract

Intravenous (IV) anesthetic agents have been used to keep the patients free from any intolerable pain or discomfort during Catheter ablation (CA) of atrial fibrillation (AF). We compared the effect of propofol (PRO) vs. pentothal (PEN) on sedation during CA of AF. Methods: In PEN group, IV administration of 1.5-2mg/kg was followed by 1mg/kg per 10 minutes and bolus IV of midazolam (M) or fentanyl (F) when required to keep motionless and painless states. In PRO group, initial 4~5pg/ml IV, which adjusted by height, weight, and age, and was followed by continuous infusion and additional bolus IV of M or F if needed. Results: 228 consecutive patients underwent CA of AF were divided into PEN (n=107) and PRO group (n=121). Mean dose of PEN and PRO was 6.8±2.0mg/kg/hr and 6.1 ± 1.2mg/kg/hr, respectively. Compared to PEN group, dosages of M and F were smaller in PRO group (M,10.0±3.3 vs 0.3±1.1mg), (F,86±36 vs 38±47pg), respectively, P<0.01. Consciousness recovery time in PRO group was shorter than that of PEN group (5.2 ± 1.7min vs. 213.5± 171.2 min, p<0.01), which also resulted in shorter hospital day in PRO group (3.6±0.9 days vs. 4.2±1.7 days in PEN group, p=0.001) Conclusion: Sedation with PRO during CA of AF was superior to PEN, i.e., minimal additional use of M and F, shorter recovery time and hospital stay without significant untoward effects. © 2011, Japanese Heart Rhythm Society. All rights reserved.