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Magnani S, Ali H, Cappato R. Ten years of subcutaneous defibrillator therapy: Consolidated clinical evidence and future perspectives. J Cardiovasc Electrophysiol 2024; 35:601-607. [PMID: 38287171 DOI: 10.1111/jce.16171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/31/2024]
Abstract
The subcutaneous implantable cardioverter defibrillator (S-ICD) was developed as an alternative to the traditional transvenous implantable cardioverter defibrillator (TV-ICD), aiming to provide easier implantation, simplified detection algorithm of malignant ventricular arrhythmias and prevention from placing components in the cardiovascular system. The S-ICD is implanted subcutaneously or intramuscularly with the generator placed in the left midaxillary line and the lead tunneled subcutaneously in the left para-sternal region. Preimplant electrocardiogram screening is recommended to prevent implantation in patients at high risk of T wave over-sensing. Currently, the S-ICD is unsuitable for patients requiring pacing or cardiac resynchronization. Since the beginning, the S-ICD underwent extensive preclinical investigation until the first prospective multicentre trial demonstrating high efficacy and safety led to market release. While earlier studies focused on younger patients with higher ejection fraction, more recent studies showed favorable outcomes even in patients with comorbidities similar to those typically observed in patients receiving TV-ICD. The development of second and third generation devices has contributed to reduce inappropriate shocks and overcome previous limitations. The aim of this paper is to review the evidence in the literature over the past decade supporting S-ICD as a valid alternative to TV-ICD in terms of safety and efficacy, highlighting the improvements in technology, as well as outcomes.
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Affiliation(s)
- Silvia Magnani
- Arrhythmia and Electrophysiology Center, IRCCS Multimedica, Milan, Italy
| | - Hussam Ali
- Arrhythmia and Electrophysiology Center, IRCCS Multimedica, Milan, Italy
| | - Riccardo Cappato
- Arrhythmia and Electrophysiology Center, IRCCS Multimedica, Milan, Italy
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Oh D, Stapleton G, Brovman EY. Utilization of Regional Anesthesia in the Electrophysiology Lab: A Narrative Review. Curr Pain Headache Rep 2023; 27:455-459. [PMID: 37572246 DOI: 10.1007/s11916-023-01147-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 08/14/2023]
Abstract
PURPOSE OF REVIEW The electrophysiology lab is an important source of growth of anesthetic volume as the indications and evidence for catheter ablations and various cardiac implantable electronic devices improve. Paired with this increase in volume is an increasing number of patients with substantial comorbid conditions presenting for their EP procedures. For these patients, the interaction between their comorbidities and traditional anesthesia practices may create the risk of hemodynamic instability, cardiovascular or respiratory complications, and potential need for prolonged post-operative monitoring negatively impacting length of hospital stay. RECENT FINDINGS Regional anesthetic techniques, including pectoralis, serratus, and erector spinae plane blocks, offer options for both regional analgesia and surgical anesthesia for a variety of EP procedures. Existing case reports and extrapolations from other areas support these techniques as viable, safe, and effective components of an anesthetic plan. In this article, we will review the development and challenges of various EP procedures and how different regional anesthetic techniques can function as a component of the anesthesia plan.
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Affiliation(s)
- David Oh
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, 800 Washington St., MA, 02111, Boston, USA
| | - Gabriel Stapleton
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, 800 Washington St., MA, 02111, Boston, USA
| | - Ethan Y Brovman
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, 800 Washington St., MA, 02111, Boston, USA.
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Janc J, Szamborski M, Milnerowicz A, Łysenko L, Leśnik P. Evaluation of the Effectiveness of Modified Pectoral Nerve Blocks Type II (PECS II) for Vascular Access Port Implantation Using Cephalic Vein Venesection. J Clin Med 2021; 10:jcm10245759. [PMID: 34945054 PMCID: PMC8703813 DOI: 10.3390/jcm10245759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022] Open
Abstract
The vascular access port implantation procedure can be performed using the venesection method by inserting a catheter into the cephalic vein in the region of the deltopectoral groove. This method eliminates the need for catheter tunneling. An alternative method to infiltration anaesthesia for port implantation may be a modified pectoral nerve block type II (PECS II). This study aimed to evaluate the effectiveness of modified PECS II for vascular access port implantation using cephalic vein venesection. This retrospective observational study was conducted at the 4th Military Clinical Hospital in Wroclaw, Poland. A group of 114 patients underwent the modified PECS II block and additional cutaneous infiltration anesthesia at the incision line. Pain intensity was assessed on the NRS scale measured intraoperatively at four points. The QoR-15 questionnaire was used to assess patient satisfaction during the first 24 h after surgery. The operator’s condition assessment score was used to assess surgical conditions and operator comfort. The analysis showed that the median pain intensity during vascular port implantation was 0. A statistically significant difference in pain intensity was demonstrated between the specialist’s group and the resident’s group at the second and third measurement points (p < 0.008; p < 0.012). The mean value on the QoR-15 scale was 132. There was a significant difference between the pain scores of the groups. The mean score in the pain position in the specialist’s group was 18 points and in the resident’s group, it was 19 points (p < 0.029). In conclusion, the present study revealed that the modified PECS II block is an effective and safe method of anesthesia for Port-A-Cath implantation.
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Affiliation(s)
- Jarosław Janc
- Department of Anaesthesiology and Intensive Therapy, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland; (J.J.); (M.S.); (L.Ł.)
| | - Marek Szamborski
- Department of Anaesthesiology and Intensive Therapy, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland; (J.J.); (M.S.); (L.Ł.)
| | - Artur Milnerowicz
- Department of Vascular Surgery, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland;
| | - Lidia Łysenko
- Department of Anaesthesiology and Intensive Therapy, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland; (J.J.); (M.S.); (L.Ł.)
| | - Patrycja Leśnik
- Department of Anaesthesiology and Intensive Therapy, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland; (J.J.); (M.S.); (L.Ł.)
- Correspondence: ; Tel.: +48-71-289-45-46
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4
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Markman TM, Brown CR, Yang L, Guandalini GS, Hyman MC, Arkles JS, Santangeli P, Schaller RD, Supple GE, Deo R, Nazarian S, Dixit S, Callans DJ, Epstein AE, Marchlinski FE, Groeneveld PW, Frankel DS. Persistent Opioid Use After Cardiac Implantable Electronic Device Procedures. Circulation 2021; 144:1590-1597. [PMID: 34780252 DOI: 10.1161/circulationaha.121.055524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Prescription opioids are a major contributor to the ongoing epidemic of persistent opioid use (POU). The incidence of POU among opioid-naïve patients after cardiac implantable electronic device (CIED) procedures is unknown. METHODS This retrospective cohort study used data from a national administrative claims database from 2004 to 2018 of patients undergoing CIED procedures. Adult patients were included if they were opioid-naïve during the 180-day period before the procedure and did not undergo another procedure with anesthesia in the next 180 days. POU was defined by filling an additional opioid prescription >30 days after the CIED procedure. RESULTS Of the 143 400 patients who met the inclusion criteria, 15 316 (11%) filled an opioid prescription within 14 days of surgery. Among these patients, POU occurred in 1901 (12.4%) patients 30 to 180 days after surgery. The likelihood of developing POU was increased for patients who had a history of drug abuse (odds ratio, 1.52; P=0.005), preoperative muscle relaxant (odds ratio, 1.52; P<0.001) or benzodiazepine (odds ratio, 1.23; P=0.001) use, or opioid use in the previous 5 years (OR, 1.76; P<0.0001). POU did not differ after subcutaneous implantable cardioverter defibrillator or other CIED procedures (11.1 versus 12.4%; P=0.5). In a sensitivity analysis excluding high-risk patients who were discharged to a facility or who had a history of drug abuse or previous opioid, benzodiazepine, or muscle relaxant use, 8.9% of the remaining cohort had POU. Patients prescribed >135 mg of oral morphine equivalents had a significantly increased risk of POU. CONCLUSIONS POU is common after CIED procedures, and 12% of patients continued to use opioids >30 days after surgery. Higher initially prescribed oral morphine equivalent doses were associated with developing POU.
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Affiliation(s)
- Timothy M Markman
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Chase R Brown
- Division of Cardiovascular Surgery (C.R.B.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Lin Yang
- Center for Cardiovascular Outcomes, Quality, and Evaluative Research, University of Pennsylvania, Philadelphia (L.Y., P.W.G., D.S.F.)
| | - Gustavo S Guandalini
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Matthew C Hyman
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Jeffrey S Arkles
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Pasquale Santangeli
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Robert D Schaller
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Gregory E Supple
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Rajat Deo
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia.,Corporal Michael J. Crescenz VA Medical Center, Philadelphia (R.D., S.D., A.E.E., P.W.G.)
| | - Saman Nazarian
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Sanjay Dixit
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia.,Corporal Michael J. Crescenz VA Medical Center, Philadelphia (R.D., S.D., A.E.E., P.W.G.)
| | - David J Callans
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Andrew E Epstein
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia.,Corporal Michael J. Crescenz VA Medical Center, Philadelphia (R.D., S.D., A.E.E., P.W.G.)
| | - Francis E Marchlinski
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Peter W Groeneveld
- Division of General Internal Medicine (P.W.G.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia.,Center for Cardiovascular Outcomes, Quality, and Evaluative Research, University of Pennsylvania, Philadelphia (L.Y., P.W.G., D.S.F.).,Corporal Michael J. Crescenz VA Medical Center, Philadelphia (R.D., S.D., A.E.E., P.W.G.)
| | - David S Frankel
- Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia.,Center for Cardiovascular Outcomes, Quality, and Evaluative Research, University of Pennsylvania, Philadelphia (L.Y., P.W.G., D.S.F.)
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Shariat A, Ghia S, Gui JL, Gallombardo J, Bracker J, Lin HM, Mohammad A, Mehta D, Bhatt H. Use of Serratus Anterior Plane and Transversus Thoracis Plane Blocks for Subcutaneous Implantable Cardioverter-Defibrillator (S-ICD) Implantation Decreases Intraoperative Opioid Requirements. J Cardiothorac Vasc Anesth 2021; 35:3294-3298. [PMID: 34140203 DOI: 10.1053/j.jvca.2021.04.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The present study investigated whether regional anesthetic techniques, especially truncal blocks, can provide adjunct anesthesia without the additional risk of general anesthesia and neuraxial techniques for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation. DESIGN Single-center, prospective, randomized study. SETTING Holding area and operating room at a single-center tertiary care hospital. PARTICIPANTS The study comprised 22 American Society of Anesthesiologists (ASA) physical status 3 or 4 patients with severe cardiac disease undergoing S-ICD implantation. INTERVENTIONS Patients received either a combination of serratus anterior plane block and transversus thoracis plane block or surgical infiltration of local anesthetics. MEASUREMENTS AND MAIN RESULTS Perioperative analgesic medication in the fascial plane block group versus the surgical wound infiltration group, visual analog pain scale score (0-10), intraoperative vital signs, total procedure time, and length of stay in the intensive care unit were measured. Total intraoperative fentanyl requirements (µg) were significantly less in the truncal block group versus the surgical infiltration group (45 [25-50] v 90 [50-100]; p = 0.026), and no patients had any adverse sequelae related to the study. Median intraoperative propofol use in the surgical infiltration group was 66.48 (47.30-73.73) µg/kg/min, and 65.95 (51.86-104.86) µg/kg/min for the truncal block group. This difference between the groups was not statistically significant (p = 0.293). CONCLUSIONS The performance of both the serratus anterior plane block and transversus thoracis plane blocks for S-ICD implantation are appropriate and may have the benefit of decreasing intraoperative opioid requirements.
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Affiliation(s)
- Ali Shariat
- Mount Sinai Morningside Medical Center, New York, NY.
| | - Samit Ghia
- Mount Sinai Morningside Medical Center, New York, NY
| | - Jane L Gui
- Mount Sinai Morningside Medical Center, New York, NY
| | | | | | - Hung-Mo Lin
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - Asad Mohammad
- Mount Sinai Morningside Medical Center, New York, NY
| | | | - Himani Bhatt
- Icahn School of Medicine at Mount Sinai, New York, NY
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Koller MP, Cortez D, Kim TW. Nerve Blocks for Postoperative Pain Management in Children Receiving Subcutaneous Implantable Cardioverter-Defibrillators: A Case Series. A A Pract 2021; 15:e01520. [PMID: 34547010 DOI: 10.1213/xaa.0000000000001520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Subcutaneous implantable cardioverter-defibrillator (S-ICD) placement may cause significant postoperative pain. Limited research exists on regional anesthesia for pediatric S-ICD placement. This case series examined transversus thoracic plane blocks (TTPBs), pectointercostal fascial plane blocks (PIFBs), pectoralis nerve I and II blocks, paravertebral, serratus anterior plane, and erector spinae plane blocks (ESPBs) in 10 children receiving S-ICDs. Parasternal nerve blocks consisting of TTPB or PIFB and left ESPB appeared to provide adequate pain control. These children had reduced opioid consumption, lower mean pain scores, longer delay in first postoperative analgesic, and no complications. Regional anesthesia may reduce pain after pediatric S-ICD implantation.
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Affiliation(s)
| | - Daniel Cortez
- Pediatrics, University of Minnesota School of Medicine, Minneapolis, Minnesota
| | - Tae W Kim
- From the Departments of Anesthesiology
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Scaglione M, Battaglia A, Lamanna A, Cerrato N, Di Donna P, Bertagnin E, Muro M, Alberto Caruzzo C, Gagliardi M, Caponi D. Adjunctive hypnotic communication for analgosedation in subcutaneous implantable cardioverter defibrillator implantation. A prospective single center pilot study. IJC HEART & VASCULATURE 2021; 35:100839. [PMID: 34307829 PMCID: PMC8287220 DOI: 10.1016/j.ijcha.2021.100839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/18/2021] [Accepted: 06/30/2021] [Indexed: 11/04/2022]
Abstract
Background Subcutaneous implantable cardioverter defibrillator (S-ICD) is a well-established therapy for sudden death prevention. Considering the painful nature of the procedure anaesthesia may be required for analgo-sedation. Hypnosis is emerging as a promising therapeutic strategy for pain control. Few data are available regarding the use of hypnosis as adjunctive technique for pain control during S-ICD implantation. Methods Thirty consecutive patients referred to our centre for S-ICD implantation were prospectively and alternatively allocated with 1:1 ratio in two groups: A) Standard analgo-sedation approach (Hypnosis non responder patients) B) Standard analgo-sedation approach with the addition of hypnotic communication (Hypnosis responder patients). Peri-procedural pain perception and anxiety, perceived procedural length, type and dosage of administered analgesic drugs have been measured using validate scores and compared. Results Hypnotic communication was offered to 15 patients of which was successful in 11 patients (73%). There were no statistical differences between the two study groups according to baseline characteristics. Hypnosis communication resulted in significant pain perception reduction (Group A 6,9 ± 1,6 Vs Group B 1,1 ± 0,9, p value < 0,01), peri-procedural anxiety (Group A 3,5 ± 1,6 Vs Group B 1,9 ± 0,5, p value < 0,01) and reduced perceived procedural length (Group A 58,7 ± 13,4 min Vs Group B 44,7 ± 5,5 min, p value < 0,01). Fentanyl dosage was significantly lower in Group B patients. Conclusions Our results demonstrated a significant reduction of perceived pain, anxiety, procedural time and use of analgesic drugs in hypnosis responder patients. These results reinforce the beneficial effects of the hypnotic technique in patients undergoing S-ICD implantation.
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Affiliation(s)
- Marco Scaglione
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | | | - Andrea Lamanna
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Natascia Cerrato
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Paolo Di Donna
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Enrico Bertagnin
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Milena Muro
- Pain Therapy and Palliative Care, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy
| | | | - Marco Gagliardi
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Domenico Caponi
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
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Zhang Y, Min J, Chen S. Analgesic Efficacy of Regional Anesthesia of the Hemithorax in Patients Undergoing Subcutaneous Implantable Cardioverter-Defibrillator Placement. J Cardiothorac Vasc Anesth 2021; 35:3288-3293. [PMID: 33836963 DOI: 10.1053/j.jvca.2021.02.052] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Patients undergoing subcutaneous implantable cardioverter-defibrillator (S-ICD) placement usually experience substantial perioperative pain. The aim of the present study was to investigate the effect of transversus thoracic muscle plane block combined with serratus anterior plane block in patients undergoing S-ICD placement. DESIGN Double-blind, randomized controlled study. SETTING First Affiliated Hospital of Nanchang University. PARTICIPANTS Patients aged 18-to-80 years who underwent new S-ICD placement. INTERVENTIONS A group of 80 patients randomly were allocated to either the regional group (R group) or local group (L group). MEASUREMENTS AND MAIN RESULTS The primary endpoint was pain during S-ICD placement. The secondary outcome measures included pain intensity at rest and after movement one, three, six, 12, 24, and 48 hours after surgery; the dose of dexmedetomidine and remifentanil during surgery; 24-hour ketorolac administration; postoperative sufentanil dosage; the total duration of hospitalization; intraoperative sedation; and the incidence of hypoxemia. Mean Critical-Care Pain Observation Tool scores were significantly higher during pocket creation, lead tunneling A, and lead tunneling B in the L group compared with the R group. The R group required significantly less intraoperative dexmedetomidine, intraoperative remifentanil, postoperative sufentanil, and ketorolac consumption. Compared with the R group, the L group had higher Numerical Rating Scale pain scores at 24 hours after surgery both at rest and after movement. The intraoperative Ramsay score and the incidence of hypoxemia were significantly higher in the L group compared with the R group. CONCLUSIONS Ultrasound-guided transversus thoracic muscle plane block and serratus anterior plane block resulted in lower intraoperative Critical-Care Pain Observation Tool scores and the need for less adjunctive pain medication and sedation compared with local anesthesia in patients undergoing S-ICD placement.
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Affiliation(s)
- Yang Zhang
- Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Jia Min
- Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Shibiao Chen
- Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Jiangxi, China.
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9
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Clavipectoral fascial plane block for implantable cardioverter defibrillator implantation. J Clin Anesth 2021; 71:110197. [PMID: 33601281 DOI: 10.1016/j.jclinane.2021.110197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 11/20/2022]
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10
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Zhang Y, Gong H, Zhan B, Chen S. Efficacy of Truncal Plane Blocks in Pediatric Patients Undergoing Subcutaneous Implantable Cardioverter-Defibrillator Placement. J Cardiothorac Vasc Anesth 2020; 35:2088-2093. [PMID: 33358456 DOI: 10.1053/j.jvca.2020.11.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Pediatric patients undergoing subcutaneous implantable cardioverter-defibrillator (S-ICD) placement usually have substantial postoperative pain. The aim of this study was to investigate the effect of the transversus thoracic muscle plane (TTMP) block combined with serratus anterior plane block (SAPB) in patients undergoing S-ICD placement. DESIGN A double-blind, randomized controlled study. SETTING First Affiliated Hospital of Nanchang University. PARTICIPANTS Patients aged nine-to-18 years undergoing S-ICD placement were included. INTERVENTIONS A group of 102 patients randomly were allocated to either receive combined nerve blocks (NER group) or no nerve block (CON group). MEASUREMENTS AND MAIN RESULTS The primary endpoint was perioperative fentanyl consumption. The secondary outcome measures included pain at rest and after movement at two, four, six, 12, 24, and 48 hours after extubation; 48-hour acetaminophen administration; time to extubation; length of stay in the postanesthesia care unit (PACU); length of hospital stay; codeine tablet consumption; and percentage of patients who had codeine tablets after discharge. The NER group reported significantly less intraoperative (4.1 μg/kg v 3.1 μg/kg, p = 0.04) and postoperative fentanyl consumption (3.8 μg/kg v 1.5 μg/kg, p = 0.006) than the CON group. Compared with the NER group, the CON group had higher Numerical Rating Scale (NRS) pain scores at 24 hours after surgery both at rest and after movement. The time to extubation (20.5 minutes v 12.6 minutes, p = 0.03) and length of stay in the PACU (30.5 minutes v 15.6 minutes, p = 0.02) were significantly decreased in the NER group compared with the CON group. The CON group had a significantly higher postoperative acetaminophen requirement than did the NER group (32 mg/kg v 16 mg/kg, p = 0.01). CONCLUSION TTMP block combined with SAPB in pediatric S-ICD placement could provide effective analgesia.
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Affiliation(s)
- Yang Zhang
- Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Haixia Gong
- Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Biming Zhan
- Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Shibiao Chen
- Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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11
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Koller MP, Cortez D, Kim TW. Nerve Blocks for Postoperative Pain Management in Children Receiving a Subcutaneous Implantable Cardioverter-Defibrillator: A Case Series. A A Pract 2020; 14:e01351. [PMID: 33236870 DOI: 10.1213/xaa.0000000000001351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Subcutaneous implantable cardioverter-defibrillator (S-ICD) placement causes significant postoperative pain. Limited research exists on nerve blocks for treating pediatric S-ICD pain. This case series presents pain outcomes in 10 children receiving nerve blocks for S-ICD placement. Nerve blocks performed include bilateral parasternal with left erector spinae plane (ESP), pectoralis with left ESP, fascial plane, and paravertebral blocks. The predominant combination of bilateral parasternal blocks with a left ESP block seemed to contribute toward adequate pain control. These children appeared to have low pain scores, low opioid consumption, and no block complications. Nerve blocks may benefit pediatric patients after S-ICD implantation.
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Affiliation(s)
- Michael P Koller
- From the University of Minnesota Medical School, Minneapolis, Minnesota
| | - Daniel Cortez
- Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota
| | - Tae W Kim
- Department of Anesthesiology, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota
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12
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Schukro C, Santer D, Prenner G, Stühlinger M, Martinek M, Teubl A, Moertl D, Schwarz S, Nürnberg M, Fiedler L, Hatala R, Khazen C. State-of-the-art consensus on non-transvenous implantable cardioverter-defibrillator therapy. Clin Cardiol 2020; 43:1084-1092. [PMID: 32794309 PMCID: PMC7533987 DOI: 10.1002/clc.23432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 07/14/2020] [Accepted: 07/17/2020] [Indexed: 01/18/2023] Open
Abstract
Within the last decade, implantable cardioverter-defibrillator (ICD) systems with non-transvenous leads were developed in order to minimize complications related to the cardiovascular position of transvenous ICD leads. This national expert consensus gives an overview of potential indications for the implantation of non-transvenous ICD systems, and provides specific recommendations for implantation, follow-up, and complication management in patients with subcutaneous ICD. Regarding particular issues like the necessity for shock efficacy testing, or the clinical outcome as compared to transvenous ICD, randomized data are expected in the near future.
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Affiliation(s)
- Christoph Schukro
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - David Santer
- Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
| | - Günther Prenner
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Graz, Austria
| | - Markus Stühlinger
- Department of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria
| | - Martin Martinek
- Department of Internal Medicine I, Ordensklinikum Linz Elisabethinen Hospital, Linz, Austria
| | - Alexander Teubl
- Department of Internal Medicine III, Wiener Neustadt State Hospital, Wiener Neustadt, Austria
| | - Deddo Moertl
- Department of Internal Medicine III, University Hospital St. Pölten, Austria
| | - Stefan Schwarz
- Department of Internal Medicine I, Kepler University Hospital Linz, Linz, Austria
| | - Michael Nürnberg
- Department of Internal Medicine III, Wilhelminen Hospital Vienna, Vienna, Austria
| | - Lukas Fiedler
- Department of Internal Medicine III, Wiener Neustadt State Hospital, Wiener Neustadt, Austria
| | - Robert Hatala
- Department of Arrhythmias and Cardiac Pacing, National Institute of Cardiovascular Diseases and Slovak Medical University, Bratislava, Slovakia
| | - Cesar Khazen
- Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
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13
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Essandoh M, Hussain N, Alghothani Y, Bhandary S. Chest Wall Fascial Plane Blocks: A Safe and Effective Analgesic Strategy for Minithoracotomy Cardiac Surgery. J Cardiothorac Vasc Anesth 2020; 34:3168-3169. [PMID: 32753325 DOI: 10.1053/j.jvca.2020.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Michael Essandoh
- Department of Anesthesiology, Division of Cardiothoracic and Vascular Anesthesia, Ohio State University Medical Center, Columbus, OH
| | - Nasir Hussain
- Department of Anesthesiology, Division of Cardiothoracic and Vascular Anesthesia, Ohio State University Medical Center, Columbus, OH
| | - Yousef Alghothani
- Department of Anesthesiology, Division of Cardiothoracic and Vascular Anesthesia, Ohio State University Medical Center, Columbus, OH
| | - Sujatha Bhandary
- Department of Anesthesiology, Division of Cardiothoracic and Vascular Anesthesia, Ohio State University Medical Center, Columbus, OH
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14
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Yang JK, Char DS, Motonaga KS, Navaratnam M, Dubin AM, Trela A, Hanisch DG, McFadyen G, Chubb H, Goodyer WR, Ceresnak SR. Pectoral nerve blocks decrease postoperative pain and opioid use after pacemaker or implantable cardioverter–defibrillator placement in children. Heart Rhythm 2020; 17:1346-1353. [DOI: 10.1016/j.hrthm.2020.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/09/2020] [Indexed: 12/31/2022]
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15
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Finnerty DT, Griffin M. Recent Developments in Cardiology Procedures for Adult Congenital Heart Disease: The Anesthesiologist's Perspective. J Cardiothorac Vasc Anesth 2020; 35:741-751. [PMID: 32762881 DOI: 10.1053/j.jvca.2020.07.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/27/2020] [Accepted: 07/09/2020] [Indexed: 12/17/2022]
Abstract
Many children born today with congenital heart disease can expect to live long into adulthood. Improvements in surgical technique and anesthetic and perioperative care have significantly increased the number of survivors. Unfortunately, as these patients progress through life they frequently require further interventions. Although surgical intervention may be required frequently, these patients can be managed in the cardiac catheterization or electrophysiology laboratory. Surgical correction of tetralogy of Fallot can leave patients with pulmonary valve dysfunction later in life. A percutaneous approach is now available for these patients, which can obviate the need for resternotomy. During deployment of the valve, anesthesiologists should be aware that compression of coronary arteries can occur. Adult congenital heart disease (ACHD) patients often require pacemaker/implantable cardioverter- defibrillator (ICD) insertion or ablation therapy. These patients may have altered cardiac anatomy, which can make endovascular procedures extremely challenging. Recent developments have made these procedures safer and more efficient. A number of congenital cardiac conditions can also be associated with orofacial abnormalities. ACHD patients, as a result, can present with challenging airways. The catheterization laboratory may not be the optimum environment for the anesthesiologist to manage a difficult airway. The requirement of transesophageal echocardiography for some cath eterization procedures needs to be considered when deciding on an airway management plan. Knowledge of the underlying cardiac anatomy and the planned procedure is advised when providing anesthesia for this complex patient group outside the theater setting.
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Affiliation(s)
- Dylan T Finnerty
- Division of Anesthesiology, Mater Misericordiae University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland.
| | - Michael Griffin
- Division of Anesthesiology, Mater Misericordiae University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
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16
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Afzal MR, Okabe T, Hsu K, Cook S, Koppert T, Weiss R. How to minimize peri-procedural complications during subcutaneous defibrillator implant? Expert Rev Cardiovasc Ther 2020; 18:427-434. [DOI: 10.1080/14779072.2020.1784006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Muhammad R. Afzal
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Toshimasa Okabe
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Kevin Hsu
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Schuyler Cook
- Department of Internal Medicine, Adena Regional Medical Center, Chillicothe, OH, USA
| | - Tanner Koppert
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Raul Weiss
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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17
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Uran C, Giojelli A, Borgogna DA, Morello G, Marullo F, Iodice P, Greco A, Accogli M, Guido A, Palmisano P. Ultrasound-guided serratus anterior plane block combined with parasternal block in subcutaneous implantable cardioverter defibrillator implantation: Results of a pilot study. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2020; 43:705-712. [PMID: 32420626 DOI: 10.1111/pace.13944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/29/2020] [Accepted: 05/10/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND The standard approach to subcutaneous defibrillator (S-ICD) implantation often requires general anesthesia or anesthesiologist-delivered deep sedation. Ultrasound-guided serratus anterior plane block (SAPB) combined with parasternal block (PSB) has been proposed in order to provide anesthesia/analgesia and to reduce the need for sedation during S-ICD implantation. In this pilot study, we compared the double-block approach (SAPB + PSB) with the single-block approach (SAPB only) and with the standard approach involving local anesthesia and sedation. METHODS We prospectively enrolled 22 patients undergoing S-ICD implantation: in 10, the single-block approach was adopted; in 12, the double-block approach. As a control group, we retrospectively enrolled 14 consecutive patients who had undergone S-ICD implantation under standard local anesthesia and sedation in the previous 6 months. Intra- and postprocedural data, including patient-reported pain intensity, were collected and compared in the three study groups. RESULTS The double-block approach was associated with a shorter procedure duration than the single-block and standard approaches (63.3 ± 7.9 vs 70.1 ± 6.8 vs 76.9 ± 7.8 min; P < .05) and with a lower dose of local an aesthetic for infiltration (18.9 ± 1.7 vs 27.5 ± 4.6 vs 44.6 ± 4.0 cc; P < .001). Both the double- and single-block approaches were associated with lower pain intensity at the device pocket and the lateral tunneling site (P < .05). The double-block approach proved superior to the other two approaches in controlling intraoperative pain at the parasternal tunneling site (P < .05). CONCLUSIONS In our study, SAPB combined with PSB was superior to SAPB alone and to the standard approach in controlling intraoperative pain during S-ICD implantation. In addition, this approach resulted in shorter procedure durations.
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Affiliation(s)
- Carlo Uran
- Cardiology and Intensive Care Unit, "San Giuseppe e Melorio" Hospital, Santa Maria Capua Vetere, Italy
| | - Angela Giojelli
- Diagnostic Imaging Unit, "San Giuseppe e Melorio" Hospital, Santa Maria Capua Vetere, Italy
| | - Donato Antonio Borgogna
- Anesthesia and Intensive Care Unit, "San Giuseppe e Melorio" Hospital, Santa Maria Capua Vetere, Italy
| | - Gerardo Morello
- Cardiology and Intensive Care Unit, "San Giuseppe e Melorio" Hospital, Santa Maria Capua Vetere, Italy
| | - Flavio Marullo
- Cardiology and Intensive Care Unit, "San Giuseppe e Melorio" Hospital, Santa Maria Capua Vetere, Italy
| | - Pietro Iodice
- Cardiology and Intensive Care Unit, "San Giuseppe e Melorio" Hospital, Santa Maria Capua Vetere, Italy
| | - Angelo Greco
- Anesthesia and Intensive Care Unit, "Card. Giovanni Panico" Hospital, Tricase, Italy
| | - Michele Accogli
- Cardiology Unit, "Card. Giovanni Panico" Hospital, Tricase, Italy
| | - Alessandro Guido
- Cardiology Unit, "Card. Giovanni Panico" Hospital, Tricase, Italy
| | - Pietro Palmisano
- Cardiology Unit, "Card. Giovanni Panico" Hospital, Tricase, Italy
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18
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Jack JM, McLellan E, Versyck B, Englesakis MF, Chin KJ. The role of serratus anterior plane and pectoral nerves blocks in cardiac surgery, thoracic surgery and trauma: a qualitative systematic review. Anaesthesia 2020; 75:1372-1385. [DOI: 10.1111/anae.15000] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2020] [Indexed: 01/17/2023]
Affiliation(s)
- J. M. Jack
- Department of Anaesthesia Toronto Western Hospital University of Toronto Toronto ON Canada
| | - E. McLellan
- Department of Anaesthesia and Peri‐operative Medicine Royal Brisbane and Women's Hospital Brisbane QLD Australia
| | - B. Versyck
- Department of Anaesthesia and Pain Medicine AZ Turnhout Turnhout Belgium
| | - M. F. Englesakis
- Library and Information Services University Health Network Toronto ON Canada
| | - K. J. Chin
- Department of Anaesthesia Toronto Western Hospital University of Toronto Toronto ON Canada
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19
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Migliore F, De Franceschi P, De Lazzari M, Miceli C, Cataldi C, Crescenzi C, Migliore M, Pittarello D, Iliceto S, Bertaglia E. Ultrasound-guided serratus anterior plane block for subcutaneous implantable cardioverter defibrillator implantation using the intermuscular two-incision technique. J Interv Card Electrophysiol 2020; 57:303-309. [PMID: 31900838 DOI: 10.1007/s10840-019-00669-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 11/14/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE Operative anaesthetic requirements and perioperative discomfort are barriers to wide adoption of the subcutaneous implantable cardioverter defibrillator (S-ICD) system, especially when the intermuscular technique is used because of the greater amount of tissue dissection. The procedure is most commonly performed under general anaesthesia (GA). There is growing interest in transitioning away from the routine use of GA and towards several alternative anaesthesia modalities for the S-ICD implant procedure without the involvement of an anaesthesiologist. We assessed the feasibility of ultrasound-guided serratus anterior plane block (US-SAPB) in patients undergoing S-ICD implantation with the intermuscular two-incision technique. METHODS The study population included 38 consecutive patients (84% male; median, 53 [46-62] years) who received S-ICD implantation using the intermuscular two-incision technique. All procedures were performed under US-SAPB and conscious sedation without the involvement of an anaesthesiologist. RESULTS The average procedure time was 67 ± 14 min. No patient experienced significant haemodynamic changes or oxygen desaturation during the period of the US-SAPB procedure and sedation; there was no need for pharmacological interventions. The entire procedure was well tolerated without discomfort or complications and with no need for GA, except in one (2.6%) patient who received GA with a laryngeal mask airway. Patients always remained able to respond appropriately to neurological monitoring during the S-ICD implantation procedure. There were no procedure-related complications. CONCLUSIONS US-SAPB and the intermuscular two-incision technique may be a promising safe and feasible combination for S-ICD implantation, overcoming the potential barrier to wider S-ICD adoption in clinical practice.
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Affiliation(s)
- Federico Migliore
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via N. Giustiniani 2, 35121, Padova, Italy.
| | - Pietro De Franceschi
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via N. Giustiniani 2, 35121, Padova, Italy
| | - Manuel De Lazzari
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via N. Giustiniani 2, 35121, Padova, Italy
| | - Carlotta Miceli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via N. Giustiniani 2, 35121, Padova, Italy
| | - Claudia Cataldi
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via N. Giustiniani 2, 35121, Padova, Italy
| | - Cinzia Crescenzi
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via N. Giustiniani 2, 35121, Padova, Italy
| | - Mauro Migliore
- Anesthesia Unit, Dell'Angelo Hospital, Venice, Mestre, Italy
| | - Demetrio Pittarello
- Cardiac Anesthesia Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Sabino Iliceto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via N. Giustiniani 2, 35121, Padova, Italy
| | - Emanuele Bertaglia
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via N. Giustiniani 2, 35121, Padova, Italy
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20
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Fitzgerald MM, Bhatt HV, Schuessler ME, Guy TS, Ivascu NS, Evans AS, Ramakrishna H. Robotic Cardiac Surgery Part I: Anesthetic Considerations in Totally Endoscopic Robotic Cardiac Surgery (TERCS). J Cardiothorac Vasc Anesth 2020; 34:267-277. [DOI: 10.1053/j.jvca.2019.02.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 02/21/2019] [Indexed: 11/11/2022]
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21
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Scaglione M, Peyracchia M, Battaglia A, Di Donna P, Cerrato N, Lamanna A, Caponi D. Subcutaneous implantable cardioverter-defibrillator implantation assisted by hypnotic communication in a patient with Brugada syndrome. HeartRhythm Case Rep 2019; 6:198-201. [PMID: 32322496 PMCID: PMC7156977 DOI: 10.1016/j.hrcr.2019.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Marco Scaglione
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | | | | | - Paolo Di Donna
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Natascia Cerrato
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Andrea Lamanna
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Domenico Caponi
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
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22
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PECS block for an ICD implantation in the super obese patient. J Clin Anesth 2019; 57:110-111. [DOI: 10.1016/j.jclinane.2019.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 03/13/2019] [Accepted: 04/02/2019] [Indexed: 11/21/2022]
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23
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Droghetti A, Fusco P, Marini M, Harizai F, Scimia P. Ultrasound‐guided serratus anterior plane block and parasternal block in cooperative sedation for S‐ICD implantation. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2019; 42:1076-1078. [DOI: 10.1111/pace.13727] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/16/2019] [Accepted: 05/16/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Pierfrancesco Fusco
- Department of Anesthesia and Intensive Care UnitSan Salvatore Academic Hospital of L'Aquila L'Aquila Italy
| | | | - Fabiola Harizai
- Department of Anesthesia and Intensive Care UnitASST Cremona Cremona Italy
| | - Paolo Scimia
- Department of Anesthesia and Intensive Care UnitASST Cremona Cremona Italy
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24
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Braver O, Semyonov M, Reina Y, Konstantino Y, Haim M, Winter J. Novel Strategy of Subcutaneous Implantable Cardioverter Defibrillator Implantation Under Regional Anesthesia. J Cardiothorac Vasc Anesth 2019; 33:2513-2516. [PMID: 31130315 DOI: 10.1053/j.jvca.2019.04.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 04/15/2019] [Accepted: 04/24/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Omri Braver
- Department of Cardiology, Soroka University Medical Center, Beer Sheva, Israel; Department of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
| | - Michael Semyonov
- Department of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel; Department of Anesthesiology, Soroka University Medical Center, Beer Sheva, Israel
| | - Yair Reina
- Department of Anesthesiology, Soroka University Medical Center, Beer Sheva, Israel
| | - Yuval Konstantino
- Department of Cardiology, Soroka University Medical Center, Beer Sheva, Israel; Department of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Moti Haim
- Department of Cardiology, Soroka University Medical Center, Beer Sheva, Israel; Department of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Joachim Winter
- Department of Cardiology and Rhythmology, Augusta Hospital, Duesseldorf, Germany
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25
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Mittnacht AJ, Shariat A, Weiner MM, Malhotra A, Miller MA, Mahajan A, Bhatt HV. Regional Techniques for Cardiac and Cardiac-Related Procedures. J Cardiothorac Vasc Anesth 2019; 33:532-546. [DOI: 10.1053/j.jvca.2018.09.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Indexed: 12/31/2022]
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Miller MA, Garg J, Salter B, Brouwer TF, Mittnacht AJ, Montgomery ML, Honikman R, Arkonac DE, Choudry S, Dukkipati SR, Reddy VY, Weiner MM. Feasibility of subcutaneous implantable cardioverter-defibrillator implantation with opioid sparing truncal plane blocks and deep sedation. J Cardiovasc Electrophysiol 2018; 30:141-148. [DOI: 10.1111/jce.13750] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 09/08/2018] [Accepted: 09/17/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Marc A. Miller
- Department of Cardiology; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai; New York New York
| | - Jalaj Garg
- Department of Cardiology; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai; New York New York
| | - Benjamin Salter
- Department of Anesthesiology; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai; New York New York
| | - Thomas F. Brouwer
- Department of Cardiology; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai; New York New York
| | - Alex J. Mittnacht
- Department of Anesthesiology; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai; New York New York
| | - Morgan L. Montgomery
- Department of Anesthesiology; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai; New York New York
| | - Rafael Honikman
- Department of Anesthesiology; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai; New York New York
| | - Derya E. Arkonac
- Department of Cardiology; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai; New York New York
| | - Subbarao Choudry
- Department of Cardiology; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai; New York New York
| | - Srinivas R. Dukkipati
- Department of Cardiology; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai; New York New York
| | - Vivek Y. Reddy
- Department of Cardiology; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai; New York New York
| | - Menachem M. Weiner
- Department of Anesthesiology; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai; New York New York
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27
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Kaya E, Jánosi RA, Azizy O, Wakili R, Rassaf T. Conscious sedation during subcutaneous implantable cardioverter-defibrillator implantation using the intermuscular technique. J Interv Card Electrophysiol 2018; 54:59-64. [DOI: 10.1007/s10840-018-0445-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
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Abstract
PURPOSE OF REVIEW Clear guidelines on when to select a subcutaneous ICD (S-ICD) over a transvenous ICD (TV-ICD) are lacking. This review will provide an overview of the most recent clinical data on S-ICD and TV-ICD therapy by pooling comparison studies in order to aid clinical decision making. RECENT FINDINGS Pooling of observational-matched studies demonstrated an incidence rate ratio (IRR) for device-related complication of 0.90 (95% CI 0.58-1.42) and IRR for lead-related complications of 0.15 (95% CI 0.06-0.39) in favor of S-ICD. The IRR for device infections was 2.00 (95% CI 0.95-4.22) in favor of TV-ICD. Both appropriate shocks (IRR 0.67 (95% CI 0.42-1.06)) and inappropriate shocks (IRR 1.17 (95% CI 0.77-1.79)) did not differ significantly between both groups. With randomized data underway, the observational data demonstrate that the S-ICD is associated with reduced lead complications, but this has not yet resulted in a significant reduction in total number of complications compared to TV-ICDs. New technologies are expected to make the S-ICD a more attractive alternative.
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Affiliation(s)
- S. W. E. Baalman
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Medical Center, University of Amsterdam, PO Box 22700, 1100 Amsterdam, DE The Netherlands
| | - A. B. E. Quast
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Medical Center, University of Amsterdam, PO Box 22700, 1100 Amsterdam, DE The Netherlands
| | - T. F. Brouwer
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Medical Center, University of Amsterdam, PO Box 22700, 1100 Amsterdam, DE The Netherlands
| | - R. E. Knops
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Medical Center, University of Amsterdam, PO Box 22700, 1100 Amsterdam, DE The Netherlands
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29
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Essandoh MK, Mark GE, Aasbo JD, Joyner CA, Sharma S, Decena BF, Bolin ED, Weiss R, Burke MC, McClernon TR, Daoud EG, Gold MR. Anesthesia for subcutaneous implantable cardioverter‐defibrillator implantation: Perspectives from the clinical experience of a U.S. panel of physicians. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2018; 41:807-816. [DOI: 10.1111/pace.13364] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 02/25/2018] [Accepted: 03/18/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Michael K. Essandoh
- Department of AnesthesiologyThe Ohio State University Wexner Medical Center Columbus OH USA
| | - George E. Mark
- Department of CardiologyCooper University Hospital Camden NJ USA
| | - Johan D. Aasbo
- The Heart Institute of ProMedica Toledo Hospital Toledo OH USA
| | - Charles A Joyner
- Department of CardiologyLevinson Heart Hospital at Chippenham and Johnston Willis Medical Center Richmond VA USA
| | - Saumya Sharma
- Department of ElectrophysiologyMcGovern Medical School ‐ University of Texas Health Science Center Houston TX USA
| | - Beningo F Decena
- Department of CardiologyTucson Medical Center and Northwest Medical Center Tucson AZ USA
| | - Eric D Bolin
- Department of Anesthesia and Perioperative MedicineMedical University of South Carolina Charleston SC USA
| | - Raul Weiss
- Division of Cardiovascular Medicine, Department of Internal MedicineThe Ohio State University Wexner Medical Center Columbus OH USA
| | | | | | - Emile G. Daoud
- Division of Cardiovascular Medicine, Department of Internal MedicineThe Ohio State University Wexner Medical Center Columbus OH USA
| | - Michael R. Gold
- Division of CardiologyMedical University of South Carolina Charleston SC USA
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30
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Patton KK. Anesthesia and SICD implantation-When less (invasive) may be more. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2018; 41:817-819. [PMID: 29718581 DOI: 10.1111/pace.13360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 04/21/2018] [Accepted: 04/24/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Kristen K Patton
- Division of Cardiology, University of Washington, Seattle, WA, USA
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