title: Sedation, analgesia, and anaesthesia variability in laboratory-based cardiac procedures: an international survey.
abstract: BACKGROUND
  There is a paucity of data regarding the type of anaesthesia used and the perception toward anaesthesia among cardiologists, anaesthesiologists, and nurses. Our objective was to describe the use of sedation during nonsurgical cardiac procedures.
  
  
  METHODS
  We designed a Web-based survey to assess anaesthesia practices during cardiac procedures. The survey was distributed to cardiologists, anaesthesiologists, and nurses through national societies and international investigator networks. The questions addressed the type of practice, type of anaesthesia used during procedures, and perceptions regarding anaesthesia.
  
  
  RESULTS
  The survey was completed by 497 participants. Sedation during cardiac catheterization was used by 77/84 (92%) of cardiologists in North America, but only by 46/121 (38%) in other countries (P < 0.0001). Use of general anaesthesia for complex procedures such as transaortic valve replacement is also more common in North America (92%) compared with other countries (76%; P = 0.004). Specific sedation-related training was provided to less than a third of nonanaesthesiologists. Although more than half of the nurses received training regarding procedural sedation, such training is provided to less than a quarter of the cardiologists. The lack of training was noted in all geographic regions.
  
  
  CONCLUSIONS
  Anaesthesia and especially sedation is frequently used during percutaneous cardiac procedures. The rate of use and perceptions regarding sedation differs among professionals and might be influenced by culture, training, and geography. There is a lack of adequate formal training in the use of sedation and analgesia for nonanaesthesia professionals.
authors.affiliation: Department of Medicine, London Health Sciences Centre and Western University, London, Ontario, Canada. Electronic address: shahar.lavi@lhsc.on.ca.
authors.forename: Shahar
authors.initials: S
authors.lastname: Lavi
authors.affiliation: McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada.
authors.forename: Sanjit S
authors.initials: SS
authors.lastname: Jolly
authors.affiliation: Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, The University of Western Ontario, London, Ontario, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bainbridge
authors.affiliation: Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, The University of Western Ontario, London, Ontario, Canada.
authors.forename: Farah
authors.initials: F
authors.lastname: Manji
authors.affiliation: Department of Medicine, London Health Sciences Centre and Western University, London, Ontario, Canada.
authors.forename: Varinder
authors.initials: V
authors.lastname: Randhawa
authors.affiliation: Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, The University of Western Ontario, London, Ontario, Canada.
authors.forename: Ronit
authors.initials: R
authors.lastname: Lavi
mesh_terms: D000768:Anesthesia, General / Q000706:statistics & numerical data*; D000776:Anesthesiology / Q000193:education; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001569:Benzodiazepines / Q000627:therapeutic use; D013504:Cardiovascular Surgical Procedures / Q000706:statistics & numerical data; D002983:Clinical Competence; D016292:Procedural Sedation / Q000706:statistics & numerical data*; D054810:Deep Sedation / Q000706:statistics & numerical data*; D020927:Dexmedetomidine / Q000627:therapeutic use; D003935:Diagnostic Techniques, Cardiovascular / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D005283:Fentanyl / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D038622:Internationality; D009020:Morphine / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use; D057184:Practice Patterns, Nurses' / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015742:Propofol / Q000627:therapeutic use; D000077208:Remifentanil; D011795:Surveys and Questionnaires
chemical_list: D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D010880:Piperidines; D001569:Benzodiazepines; D020927:Dexmedetomidine; D009020:Morphine; D000077208:Remifentanil; D005283:Fentanyl; D015742:Propofol