Monitored Anesthesia Care for Cardiovascular Interventions

다국어 초록 (Multilingual Abstract)

The interventional cardiology is growing and evolving. Many complex procedures are now performed outside the operating room to manage cardiovascular pathologies which had been traditionally treated with cardiac surgery. Appropriate sedation strategy is crucial for improved patient comfort and successful procedure while ensuring safety. Sedation for cardiovascular intervention is frequently challenging, especially in critically-ill, high-risk patients. This review addresses pre-procedure evaluation and preparation of patients, proper monitoring, commonly used sedatives and analgesics, and considerations for specific procedures. Appropriate depth of sedation and analgesia should be balanced with patient, procedural and institutional factors. Understanding of the pharmacology of sedatives/analgesics, vigilant monitoring, ability and proper preparation for management of potential complications may improve outcomes in patients undergoing sedation for cardiovascular procedures.

참고문헌 (Reference)

1 Khan ZP, "alpha-2 and imidazoline receptor agonists. Their pharmacology and therapeutic role" 54 : 146-165, 1999

2 정성미, "Validity of bispectral index monitoring during deep sedation in children with spastic cerebral palsy undergoing injection of botulinum toxin" 대한마취통증의학회 72 (72): 592-598, 2019

3 최지원, "Trends in medical disputes involving anesthesia during July 2009–June 2018: an analysis of the Korean Society of Anesthesiologists database" 대한마취통증의학회 72 (72): 156-162, 2019

4 Khan LC, "Treatment of a paradoxical reaction to midazolam with haloperidol" 85 : 213-215, 1997

5 Ebert TJ, "The effects of increasing plasma concentrations of dexmedetomidine in humans" 93 : 382-394, 2000

6 강동희, "The correlation of heart rate between natural sleep and dexmedetomidine sedation" 대한마취통증의학회 72 (72): 163-168, 2019

7 Jackson BF, "Successful flumazenil reversal of paradoxical reaction to midazolam in a child" 48 : e67-72, 2015

8 Goodman NW, "Some ventilatory effects of propofol as sole anaesthetic agent" 59 : 1497-1503, 1987

9 Metzner J, "Risks of anesthesia or sedation outside the operating room : the role of the anesthesia care provider" 23 : 523-531, 2010

10 Forster A, "Respiratory depression by midazolam and diazepam" 53 : 494-497, 1980

11 Servin F, "Remifentanil; from pharmacological properties to clinical practice" 523 : 245-260, 2003

12 Sae Young Kim, "Reduction of propofol injection pain by utilizing the gate control theory" 대한마취통증의학회 61 (61): 288-291, 2011

13 Fruchter O, "Prospective randomized trial of bispectral index monitoring of sedation depth during flexible bronchoscopy" 87 : 388-393, 2014

14 Bryson HM, "Propofol. An update of its use in anaesthesia and conscious sedation" 50 : 513-559, 1995

15 Brechmann T, "Propofol sedation during gastrointestinal endoscopy arouses euphoria in a large subset of patients" 6 : 536-546, 2018

16 Salukhe TV, "Propofol sedation administered by cardiologists without assisted ventilation for long cardiac interventions : an assessment of 1000 consecutive patients undergoing atrial fibrillation ablation" 14 : 325-330, 2012

17 Bauer TM, "Prolonged sedation due to accumulation of conjugated metabolites of midazolam" 346 : 145-147, 1995

18 Bell A, "Profiling adverse respiratory events and vomiting when using propofol for emergency department procedural sedation" 19 : 405-410, 2007

19 Agrawal D, "Preprocedural fasting state and adverse events in children undergoing procedural sedation and analgesia in a pediatric emergency department" 42 : 636-646, 2003

20 김덕경, "Practice guidelines for propofol sedation by non-anesthesiologists : the Korean Society of Anesthesiologists Task Force recommendations on propofol sedation" 대한마취통증의학회 69 (69): 545-554, 2016

21 "Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration" 126 : 376-393, 2017

22 "Practice Guidelines for Moderate Procedural Sedation and Analgesia. Practice guidelines for moderate procedural sedation and analgesia 2018: a report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology" 128 : 437-479, 2018

23 Bennett SN, "Postoperative infections traced to contamination of an intravenous anesthetic, propofol" 333 : 147-154, 1995

24 Schüttler J, "Population pharmacokinetics of propofol : a multicenter study" 92 : 727-738, 2000

25 Harrison SJ, "Physician administered sedation for DC cardioversion" 88 : 117-118, 2002

26 Pentikäinen PJ, "Pharmacokinetics of midazolam following intravenous and oral administration in patients with chronic liver disease and in healthy subjects" 29 : 272-277, 1989

27 Mancuso CE, "Paradoxical reactions to benzodiazepines : literature review and treatment options" 24 : 1177-1185, 2004

28 Golparvar M, "Paradoxical reaction following intravenous midazolam premedication in pediatric patients-a randomized placebo controlled trial of ketamine for rapid tranquilization" 14 : 924-930, 2004

29 Mamiya H, "Pain following intravenous administration of sedative agents : a comparison of propofol with three benzodiazepines" 45 : 18-21, 1998

30 유정희, "Monitored anesthesia care in and outside the operating room" 대한마취통증의학회 69 (69): 319-326, 2016

31 Raza SM, "Midazolam causes no adverse hemodynamic effects in cardiac patients" 10 : 40-43, 1987

32 Robinson BJ, "Mechanisms whereby propofol mediates peripheral vasodilation in humans. Sympathoinhibition or direct vascular relaxation?" 86 : 64-72, 1997

33 Bhananker SM, "Injury and liability associated with monitored anesthesia care : a closed claims analysis" 104 : 228-234, 2006

34 Dahan A, "Influence of propofol on the control of breathing" 523 : 81-92, 2003

35 Cho JS, "Improved sedation with dexmedetomidine-remifentanil compared with midazolam-remifentanil during catheter ablation of atrial fibrillation : a randomized, controlled trial" 16 : 1000-1006, 2014

36 Skarvan K, "Hemodynamic interaction between midazolam and alfentanil in coronary patients" 35 : 17-23, 1986

37 Di Biase L, "General anesthesia reduces the prevalence of pulmonary vein reconnection during repeat ablation when compared with conscious sedation : results from a randomized study" 8 : 368-372, 2011

38 Agarwal A, "Fluid deprivation before operation. The effect of a small drink" 44 : 632-634, 1989

39 Di Biase L, "Esophageal capsule endoscopy after radiofrequency catheter ablation for atrial fibrillation : documented higher risk of luminal esophageal damage with general anesthesia as compared with conscious sedation" 2 : 108-112, 2009

40 Criqui MH, "Epidemiology of peripheral artery disease" 116 : 1509-1526, 2015

41 Pires LA, "Electrophysiological effects of propofol on the normal cardiac conduction system" 87 : 319-324, 1996

42 Paspatis GA, "Efficacy of bispectral index monitoring as an adjunct to propofol deep sedation for ERCP : a randomized controlled trial" 41 : 1046-1051, 2009

43 Niksch A, "Effects of remifentanil anesthesia on cardiac electrophysiologic properties in children undergoing catheter ablation of supraventricular tachycardia" 31 : 1079-1082, 2010

44 Larsen R, "Effects of propofol on cardiovascular dynamics and coronary blood flow in geriatric patients. A comparison with etomidate" 43 (43): 25-31, 1988

45 이성헌, "Dexmedetomidine: present and future directions" 대한마취통증의학회 72 (72): 323-330, 2019

46 Hsu YW, "Dexmedetomidine pharmacodynamics : part I : crossover comparison of the respiratory effects of dexmedetomidine and remifentanil in healthy volunteers" 101 : 1066-1076, 2004

47 Guo TZ, "Dexmedetomidine injection into the locus ceruleus produces antinociception" 84 : 873-881, 1996

48 Bhana N, "Dexmedetomidine" 59 : 263-268, 2000

49 Wutzler A, "Deep sedation during catheter ablation for atrial fibrillation in elderly patients" 38 : 115-121, 2013

50 Hughes MA, "Context-sensitive half-time in multicompartment pharmacokinetic models for intravenous anesthetic drugs" 76 : 334-341, 1992

51 Litman RS, "Conscious sedation with remifentanil during painful medical procedures" 19 : 468-471, 2000

52 Shabanie A, "Conscious sedation for interventional procedures : a practical guide" 9 : 84-88, 2006

53 Kazama T, "Comparison of the effect-site keOs of propofol for blood pressure and EEG bispectral index in elderly and younger patients" 90 : 1517-1527, 1999

54 Angst MS, "Comparative analgesic and mental effects of increasing plasma concentrations of dexmedetomidine and alfentanil in humans" 101 : 744-752, 2004

55 Sahinovic MM, "Clinical pharmacokinetics and pharmacodynamics of propofol" 57 : 1539-1558, 2018

56 Lau W, "Cardiac electrophysiologic effects of midazolam combined with fentanyl" 72 : 177-182, 1993

57 Cacho G, "Capnography is superior to pulse oximetry for the detection of respiratory depression during colonoscopy" 102 : 86-89, 2010

58 Qadeer MA, "Capnographic monitoring of respiratory activity improves safety of sedation for endoscopic cholangiopancreatography and ultrasonography" 136 : 1568-1576, 2009

59 von Delius S, "Bispectral index monitoring of midazolam and propofol sedation during endoscopic retrograde cholangiopancreatography : a randomized clinical trial(the EndoBIS study)" 44 : 258-264, 2012

60 Park JH, "Anesthetic efficacy of dexmedetomidine versus midazolam when combined with remifentanil for percutaneous transluminal angioplasty in patients with peripheral artery disease" 8 : E472-, 2019

61 Lewis SR, "Anaesthetic and sedative agents used for electrical cardioversion" CD010824-, 2015

62 Kalogridaki M, "Anaesthesia for cardioversion : a prospective randomised comparison of propofol and etomidate combined with fentanyl" 52 : 483-488, 2011

63 Weaver CS, "An assessment of the association of bispectral index with 2 clinical sedation scales for monitoring depth of procedural sedation" 25 : 918-924, 2007

64 Giovannitti JA Jr, "Alpha-2 adrenergic receptor agonists : a review of current clinical applications" 62 : 31-39, 2015

65 Trentman TL, "Airway interventions in the cardiac electrophysiology laboratory : a retrospective review" 23 : 841-845, 2009

66 Riker RR, "Adverse events associated with sedatives, analgesics, and other drugs that provide patient comfort in the intensive care unit" 25 : 8S-18S, 2005