Comparison of the electrophysiological effects of inhalational anesthesia with sevoflurane versus total intravenous anesthesia with propofol in children undergoing radiofrequency catheter ablation for tachyarrhythmias. A randomized-controlled study

Document Type : Original Article

Authors

1 Department of Anesthesia, Faculty of Medicine, Cairo University, Egypt.

2 Department of pediatrics Faculty of Medicine, Cairo University, Egypt.

10.21608/asja.2024.255356.1039

Abstract

Background: Radiofrequency catheter ablation (RFCA) is performed under general anesthesia in children and is the preferable interventional therapy for tachyarrhythmia. Two commonly used anesthetic agents were studied: sevoflurane and propofol. Method: In this study, 86 patients ranging from 1 to 14 years old undergoing ablation, were assessed for eligibility, 19 patients did not meet the criteria and 7 patients refused to participate in the study. Patients with contraindications to the use of sevoflurane or propofol including heart failure, uncontrolled asthma or malignant hyperthermia, also patients with previous ablation were excluded due to difficult cardiac mapping. The remaining patients were randomly allocated into two equal groups (30 patients in each) and assigned to receive either sevoflurane- or propofol-maintained anesthetic. The ability to induce sustained tachycardia (using a scoring system), procedural durations, effects on hemodynamic status and postoperative complications were compared between the two groups.
Results: Our study showed that the mapping time was significantly lower in the sevoflurane group than the propofol group (P=0.018). Radiofrequency procedure time, total anesthesia time and mapping/total anesthesia time were insignificantly different between both groups. Failed ablation, postoperative nausea and vomiting (PONV) and ventricular tachycardia were insignificantly different between both groups while excessive secretion was significantly lower in the sevoflurane group than the propofol group. Conclusion: Sevoflurane and propofol-based anesthesia were equally suitable in children undergoing Radiofrequency catheter ablation in pediatrics regarding inducibility of arrythmias except that the mapping time was shorter with sevoflurane.

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