title: Conscious sedation using dexmedetomidine for percutaneous transcatheter closure of atrial septal defects: A single center experience.
abstract: OBJECTIVE
  The aim of this study is to determine safety and feasibility of conscious sedation using dexmedetomidine for transcatheter atrial septal defect (ASD) device closure.
  
  
  METHODS
  A retrospective institutional review of transcatheter ASD device closure without endotracheal intubation over 18 months. The protocol included topical oropharyngeal anesthesia using lignocaine followed by dexmedetomidine bolus 1 μg/kg intravenously over 10 min and maintenance dose 0.2-0.7 μg/kg/h. Ramsay sedation score 2-3 was maintained. Patients were analyzed regarding demographic profile, device size, procedure time, anesthesia time, recovery time, hospital stay, and any hemodynamic or procedural complications.
  
  
  RESULTS
  A total of 43 patients with mean age 31.56 ± 13.74 years (range: 12-56 years) were analyzed. Mean anesthesia duration was 71.75 + 21.08 min. Mean recovery time was 7.6 ± 3.01 min. 16 females and one male patient required additional propofol with a mean dose of 30.8 ± 10.49 mg. No hemodynamic instability was noted. No patient required general anesthesia with endotracheal intubation. The procedure was successful in 93.02% of patients. Four patients developed atrial fibrillation. All patients were satisfied.
  
  
  CONCLUSIONS
  Conscious sedation using dexmedetomidine is a safe and effective anesthetic technique for percutaneous ASD closure.
authors.affiliation: Department of Anesthesiology, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: Pushkar Mahendra
authors.initials: PM
authors.lastname: Desai
authors.affiliation: Department of Anesthesiology, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: Sanjeeta R
authors.initials: SR
authors.lastname: Umbarkar
authors.affiliation: Department of Anesthesiology, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: Manjula S
authors.initials: MS
authors.lastname: Sarkar
authors.affiliation: Department of Cardiology, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: Rishi
authors.initials: R
authors.lastname: Lohiya
mesh_terms: D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization; D002648:Child; D016292:Procedural Sedation / Q000379:methods*; D020927:Dexmedetomidine; D005240:Feasibility Studies; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055989:Septal Occluder Device; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine