Incidence of nausea/vomiting following propofol sedation with adaptive servo‐ventilation for atrial fibrillation ablation

Incidence of nausea/vomiting following propofol sedation with adaptive servo‐ventilation for atrial fibrillation ablation

Background Postoperative nausea and vomiting (PONV) following atrial fibrillation (AF) ablation can cause considerable distress. Aim Continuous intravenous propofol sedation with adaptive servo‐ventilation (ASV) with or without an analgesic, pentazocine, during AF ablation was studied in 272 consecu...

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Bibliographic Details
Published in:Journal of arrhythmia Vol. 40; no. 2; pp. 289 - 296
Main Authors: Sakanoue, Haruna, Yamaji, Hirosuke, Okamoto, Sayaka, Okano, Kumi, Fujita, Yuka, Higashiya, Shunichi, Murakami, Takashi, Kusachi, Shozo
Format: Journal Article
Language:English
Published: Japan John Wiley & Sons, Inc 01-04-2024
Wiley
Subjects:
Ablation
Analgesics
Anesthesia
anesthetic
Atrial fibrillation
Body mass index
Cardiac arrhythmia
Care and treatment
catheter
Catheters
Causes of
Ejection fraction
Embolisms
Females
gastrointestinal symptoms
Gender
Motion sickness
Nausea
Patient outcomes
Patients
Performance evaluation
postoperative complaint
Respiration
supraventricular arrhythmia
Vomiting
Japan
United States > US
supraventricular arrhythmia
anesthetic
catheter
postoperative complaint
gastrointestinal symptoms
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Summary:Background Postoperative nausea and vomiting (PONV) following atrial fibrillation (AF) ablation can cause considerable distress. Aim Continuous intravenous propofol sedation with adaptive servo‐ventilation (ASV) with or without an analgesic, pentazocine, during AF ablation was studied in 272 consecutive patients with paroxysmal, persistent, and long‐standing persistent AF. The study objectives were to determine the incidence of PONV after AF ablation and to assess the predictive value of factors for PONV using the area under the receiver operating characteristic curve (AUC). Results The present sedation maneuver was successfully accomplished with a low incidence of hypotension and without discontinuation of ablation or switching to general anesthesia, while maintaining an acceptable procedural time (102 ± 32 min). The incidence of PONV was 5.5% (15/272). Nausea occurred in nine patients after an average of 4.6 ± 3.5 h (range: 2–12 h) postablation, and vomiting with nausea occurred in six patients after an average of 4.5 ± 3.1 h (range: 1–9 h) postablation. The postablation interval did not differ significantly between the occurrence of nausea and nausea accompanied by vomiting. AUCs based on various factors, including the Apfel score, ranged from 0.55 to 0.67, indicating low accuracy in predicting PONV occurrence. Conclusions The incidence of PONV after propofol sedation with ASV was the lowest (5.5%) reported to date. Scoring systems, which included the Apfel score, were ineffective in predicting PONV. The low PONV incidence in addition to the efficacy of propofol sedation with ASV revealed the adequacy of this regimen for AF ablation. The present study is the first to show that the incidence of nausea and/or vomiting was low (5.5%) after deep sedation with propofol combined with adaptive‐servo ventilation for atrial fibrillation ablation. The scoring system, which included the Apfel score, was not effective in predicting PONV.
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ISSN:1880-4276
1883-2148
DOI:10.1002/joa3.13012