11/29/2023 0 Comments Project heartbeat moderate sedation![]() ![]() The aim of this prospective, open-blinded, randomized study is to compare the feasibility of sedation with midazolam, administered exclusively by a cardiologist, to an anaesthesiologist-assisted protocol with propofol in urgent or emergency DCC. However, concerns have been raised on the use of a cardiologist-only, midazolam-based strategy in urgent or emergency DCC as haemodynamic instability and lack of time could precipitate the risk of stroke and serious adverse events. In particular, the use of a cardiologist-only approach to sedation with midazolam for elective DCC has been described in literature and demonstrated to be as tolerated and effective as propofol in elective procedures. In order to overcome such a limitation, non-anaesthesiologists, such as cardiologists, emergency physicians or nurses have sought potential alternatives such as benzodiazepines. One of the most commonly used agent for sedation in DCC, is propofol an intravenous sedative hypnotic drug which can be administered only by personnel trained in advanced airways management. To this day, no specific guidelines or recommendations with regards to the most appropriate drug that should be used for procedural sedation is available and different sedation strategies have been described in literature but no consensus on the most efficient strategy has been reached. The use of sedation during DCC can also play a role in reducing the pain-related catecholamine surge therefore preventing the recollection of such an unpleasant experience by the patient. It therefore requires both analgesia and deep sedation which, according to the American Society of Anaesthesiologists, consists in a drug induced reduction of the level of consciousness, during which patients can respond purposefully to painful stimuli. DCC is, however, a painful procedure that can cause pain comparable to a surgical incision. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.ĭirect current cardioversion (DCC) represents the most widely used and effective method to restore sinus rhythm in patients with persistent atrial fibrillation (AF). ![]() If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
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