title: Can we implant cardioverter defibrillator under minimal sedation?
abstract: Aim In a prospective study, we tested the feasibility of implantable cardioverter-defibrillator (ICD) implantation under local anaesthesia (LA) with minimal sedation (MS) vs. short general anaesthesia (SGA) for defibrillation test (DT).
  
  
  RESULTS
  We implanted ICDs in 118 patients between October 2002 and November 2003. Surgery was performed under LA with MS. Depending on the day of admission, patients had DT without SGA with a shock delivered when patient is unconscious (MS group, n = 73) or with short general anaesthesia (SGA group, n = 45). The patients were asked to rate the intensity of pain on a 10-point visual analogue scale (VAS) at the end of the implantation procedure and for the patient of MS group just after DT (VAS-DT). Visual analogue scale was not influenced by the type of anaesthesia (MS vs. SGA). Univariate analysis showed that NYHA >III, 3 leads implanted and an incomplete understanding of the explanation on the procedure were risk factors of VAS >4. Only understanding of the explanation on the procedure has an influence on pain in multivariate analysis.
  
  
  CONCLUSIONS
  ICD implantation under MS even for DT is feasible and acceptable for the patient.
authors.affiliation: Department of Cardiology A, Hôpital Cardiologique de Lille, CHRU, Blvd du Pr Leclercq, F-59037 Lille (Cedex), France. c-marquie@chru-lille.fr
authors.forename: Christelle
authors.initials: C
authors.lastname: Marquié
authors.forename: Audrey
authors.initials: A
authors.lastname: Duchemin
authors.forename: Didier
authors.initials: D
authors.lastname: Klug
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lamblin
authors.forename: Frédérique
authors.initials: F
authors.lastname: Mizon
authors.forename: Hélène
authors.initials: H
authors.lastname: Cordova
authors.forename: Marie
authors.initials: M
authors.lastname: Boulo
authors.forename: Dominique
authors.initials: D
authors.lastname: Lacroix
authors.forename: Annie
authors.initials: A
authors.lastname: Pol
authors.forename: Salem
authors.initials: S
authors.lastname: Kacet
mesh_terms: D000368:Aged; D000768:Anesthesia, General / Q000379:methods; D000772:Anesthesia, Local / Q000379:methods*; D016009:Chi-Square Distribution; D016292:Procedural Sedation / Q000379:methods*; D017147:Defibrillators, Implantable; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome