Dexmedetomidine versus propofol-opioid for sedation in transcatheter aortic valve implantation patients: a retrospective analysis of periprocedural gas exchange and hemodynamic support

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
N Patrick MayrPeter Tassani-Prell

Abstract

Different sedation regimens have been described for use during transfemoral transcatheter aortic valve implantation (tf-TAVI) for treatment in patients with severe aortic stenosis. The purpose of this study was to compare dexmedetomidine (DEX) with a combination of propofol-opioid (PO) with respect to periprocedural gas exchange and hemodynamic support. Data from a cohort of patients sedated with either DEX or PO for tf-TAVI were retrospectively analyzed from a prospectively maintained TAVI registry. Operative risk was determined from comorbidities and risk scores. Periprocedural partial pressure of carbon dioxide (PaCO2) was chosen as the primary endpoint. Other differences in gas exchange, need for catecholamine therapy, the frequency of conversion to general anesthesia, and need for sedative "rescue therapy" (in DEX patients) were secondary endpoints. Inverse probability of treatment weighting (IPTW) was used for analysis to minimize any selection bias. Of the 297 patients (140 PO, 157 DEX) included, the median [interquartile range] periprocedural PaCO2 values of DEX patients were significantly lower than in PO patients (40 [36-45] mmHg vs 44 [40-49] mmHg, respectively; median difference -4 mmHg; 95% confidence interval, -5 ...Continue Reading

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Citations

Apr 17, 2020·Advances in Therapy·Loredana CristianoMaria Caterina Pace
May 2, 2021·Revista española de anestesiología y reanimación·L Martinez-DolzUNKNOWN Grupo de trabajo de Sedación tutelada en procedimientos de intervencionismo en Cardiología de la Sociedad Española de Aneste
Jun 3, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Vivian DoanLavinia M Kolarczyk
Jun 21, 2021·Revista Española De Anestesiología Y Reanimación·L Martinez-DolzUNKNOWN Working Group on Tutored Sedation in Interventional Procedures in Cardiology of the Spanish Society of Anesthesia Resuscitat

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