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Perioperative analgesic efficacy of a single, pre-emptive administration of propacetamol in catheter ablation for atrial fibrillation: a randomized controlled trial

 Sung-Yeon HAM  ;  Jong-Wook SONG  ;  Jae-Kwang SHIM  ;  Woo-Kyung LEE  ;  Hee-Jung KIM  ;  Young-Lan KWAK 
 MINERVA ANESTESIOLOGICA, Vol.84(6) : 675-683, 2018 
Journal Title
Issue Date
Atrial fibrillation ; Catheter ablation ; Conscious sedation ; Propacetamol ; Remifentanil
BACKGROUND: Anesthetic care for termination of atrial fibrillation with catheter ablation poses significant challenges due to significant pain and lengthy procedure. A delicate polypharmacy combining anesthetic agents to minimize respiratory depression and hemodynamic changes and to provide satisfactory sedation and analgesia is needed.

METHODS: Ninety-eight patients were randomized into two groups receiving either two grams of propacetamol or normal saline intravenously for 20 minutes before anesthesia. Monitored anesthesia care was provided with midazolam and remifentanil.

RESULTS: Total amounts of remifentanil infused were similar between the groups (626±251 vs. 597±315 μg, P=0.606). Accounting for the mean duration of the procedure and the elimination half-life of propacetamol, remifentanil requirements were significantly less among patients whose procedure ended within 180 minutes (N.=56) in the propacetamol group than those in the control group (540±194 vs. 421±164 μg, P=0.017). In the control group, the incidence of analgesics usage 24 hours after the procedure was significantly greater (43% vs. 23%, P=0.038), and patients exhibited a higher pain score (3.1±2.1 vs. 1.9±2.1, P=0.007), compared to the propacetamol group.

CONCLUSIONS: The addition of a single dose of pre-emptive propacetamol showed promising results in terms of opioid consumption in patients whose procedure ended within 180 minutes. It provided better post-procedural pain control, compared with midazolam plus remifentanil alone.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Song, Jong Wook(송종욱) ORCID logo https://orcid.org/0000-0001-7518-2070
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Lee, Yong Kyung(이용경)
Ham, Sung Yeon(함성연) ORCID logo https://orcid.org/0000-0001-8619-4595
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