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MINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Anestesiologica 2017 Nov 06

DOI: 10.23736/S0375-9393.17.12268-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Periprocedural analgesic efficacy of a single, pre-emptive administration of propacetamol in catheter ablation for atrial fibrillation: a randomized controlled trial

Sung Yeon HAM 1, Jong-Wook SONG 1, 2, 3, Jae-Kwang SHIM 1, 2, 3, Woo Kyung LEE 1, Hee-Jung KIM 1, Young-Lan KWAK 1, 2, 3

1 Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; 2 Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; 3 Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea


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BACKGROUND: Anesthetic care for termination of atrial fibrillation with catheter ablation poses significant challenges due to significant pain lengthy procedure. A delicate polypharmacy combining anaesthetic agents to minimize respiratory depression and hemodynamic changes and to provide satisfactory sedation and analgesia is needed.
METHODS: Ninety-eight patients were randomized into two groups receiving either two gram of propacetamol or normal saline intravenously for 20 min before anesthesia. Monitored anesthesia care was provided with midazolam and remifentanil.
RESULTS: Total amounts of remifentanil infused were similar between the groups (626±251 μg vs. 597±315 μg, P = 0.606). Accounting for the mean duration of the procedure and the elimination half-life of propacetamol, remifentanil requirements were significantly less among patients whose procedure ended within 180 min (n = 56) in the Propacetamol group than those in the Control group (540±194 μg vs. 421±164 μg, P = 0.017). In the Control group, the incidence of analgesics usage 24 h after the procedure was significantly greater (43% vs. 23%, P = 0.038), and patients exhibited a higher pain score (3.1±2.1 vs. 1.9±2.1, P = 0.007), compared to the Propacetamol group.
CONCLUSIONS: The addition of a single dose of pre-emptive propacetamol showed promising results in terms of opioid consumption in patients whose procedure ended within 180 min. It provided better post-procedural pain control, compared with midazolam plus remifentanil alone.


KEY WORDS: Atrial fibrillation - Catheter ablation - Conscious Sedation - Propacetamol - Remifentanil

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Publication History

Article first published online: November 06, 2017
Manuscript accepted: October 24, 2017
Manuscript revised: September 27, 2017
Manuscript received: June 30, 2017

Per citare questo articolo

Ham SY, Song JW, Shim JK, Lee WK, Kim HJ, Kwak YL. Periprocedural analgesic efficacy of a single, pre-emptive administration of propacetamol in catheter ablation for atrial fibrillation: a randomized controlled trial. Minerva Anestesiol 2017 Nov 06. DOI: 10.23736/S0375-9393.17.12268-6

Corresponding author e-mail

ylkwak@yuhs.ac