How much propofol is needed for a cardioversion?

Propofol appears safe and effective in procedural sedation

procedural sedation

Procedural sedation and analgesia (PSA) is a technique in which a sedating/dissociative medication is given, usually along with an analgesic medication, in order to perform non-surgical procedures on a patient.

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Procedural sedation and analgesia - Wikipedia

for cardioversion. 1. Propofol at a dose of 1 mg/kg for hemodynamically stable patients and 0.5mg/kg in hemodynamically unstable patients appears to be a safe drug for procedural sedation in DC cardioversion of atrial tachyarrhythmias

tachyarrhythmias

Tachycardia-induced cardiomyopathy (TIC) is a disease where prolonged tachycardia (a fast heart rate) or arrhythmia (an irregular heart rhythm) causes an impairment of the myocardium (heart muscle), which can result in heart failure.

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Tachycardia-induced cardiomyopathy - Wikipedia

. 2.

What type of sedation is used for cardioversion?

RICHARD SADOVSKY, M.D. Deep sedation is desirable during cardioversion performed to treat cardiac arrhythmias. Because this procedure is often performed in an emergency situation when the arrhythmia is causing patient instability, sedation must be quick and compatible with the possibility of a full stomach.

Does cardioversion require IV sedation?

No or minimal sedation can be associated with serious psychological sequela. Brief general anesthesia is required for elective cardioversion in hemodynamically stable patients.

How much propofol is given?

Most patients will require 0.5 - 1 mg propofol/kg body weight over 1 to 5 minutes for onset of sedation. Maintenance of sedation may be accomplished by titrating Propofol to the desired level of sedation. Most patients will require 1.5 - 4.5 mg propofol/kg body weight/h.

Why is propofol used in cardioversion?

At the same time, anaesthetic should not cause hemodynamic disturbances and should be devoid of unwanted side effects without losing airway reflex control. Propofol and etomidate both fulfil majority of these criteria as an ideal anaesthetic agent for cardioversion.

What you need to know about propofol.

Are you asleep during cardioversion?

Because the shock would be painful for a patient who is awake, an intravenous medication is given to sedate the patient. Patients are asleep during the cardioversion and most do not remember the procedure. It is not usually necessary to have a breathing tube (endotracheal tube) placed before the procedure.

Is conscious sedation included in cardioversion?

In summary, conscious sedation is a safe and effective method and an alternative to general anaesthesia in patients undergoing electrical cardioversion.

Is 300 mg of propofol a lot?

Caution is required during administration to avoid deep anesthesia. Generally, a propofol loading dose of 40 mg to 50 mg is given with further smaller bolus loads (10 mg to 20 mg) to maintain sedation, with a typical total dose between 100 mg and 300 mg.

How much propofol do you need for conscious sedation?

Generally, start with an initial bolus dose of 0.5–1.0 mg/kg for adults or 1.5–2.0 mg/kg for children. Titrate every 1 to 3 minutes to effect with boluses of 0.25–0.5mg/kg (adults) or 0.5-1.0 (children).

What level of sedation is propofol?

It has no analgesic effects; therefore, when used for moderate sedation, propofol frequently has to be administered in amounts to provide deep levels of sedation to allow a painful procedure to be performed.

Is cardioversion done under general anesthesia?

Abstract. Elective cardioversion is a short procedure performed under general anesthesia for the treatment of cardiac dysrhythmias. Selection of the anesthetic agent is important, because a short duration of action and hemodynamic stability are required.

How do you sedate for DC cardioversion?

All available anesthetic drugs have some limitations for DC cardioversion, and no current guideline specifies which anesthetic drug should be used. Therefore, the following three main drugs are most commonly used for this procedure: midazolam, etomidate, and propofol.

What are the side effects of propofol?

Is propofol moderate or deep sedation?

The use of propofol increases the success of satisfactory deep sedation, but it can produce rapid and profound decreases in level of consciousness and cardiorespiratory function. Data are needed to assess the safety of this drug outside an anesthesiology setting.

How long does propofol sedation last?

The elimination half-life of propofol is approximately 0.5 h to 1.5 h. This drug has a very fast clearance and therefore can be administered as a continuous infusion or as multiple boluses without any accumulative effects.

Can you overdose on propofol?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur. Propofol can cause severe drowsiness or dizziness, which may last for several hours. You will need someone to drive you home after your surgery or procedure.

How fast do you wake up from propofol?

Propofol has a rapid distribution half-life which leads to rapid awakening from a bolus dose of approximately 8–10 minutes.

Do patients talk under propofol?

Patients do not talk during the anaesthetic while they are unconscious, but it is not uncommon for them to do so during emergence from anaesthesia.

Are you awake during propofol?

"You feel alert, unlike with [the anesthetic] pentothal, which left patients feeling really worn out and hungover," Dombrowski says. "But while propofol induces sleep, it's not a clean, clear sleep."

What medications should be held prior to cardioversion?

Preparing for the procedure

If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your procedure. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.

What should you not do before cardioversion?

THE DAY BEFORE YOUR CARDIOVERSION

During this call you will also be instructed where you should check in once you arrive at MGH. Since you will receive anesthesia, it is essential that you: 1. Do not eat or drink after midnight the night before your procedure.

What should you not do after cardioversion?

As you have been given a short general anaesthetic for the procedure, you should not drive for the next 24 hours (your insurance will not cover you). For the next 24 hours: do not go to work • do not operate machinery • do not make important decisions • do not sign legally binding documents • do not drink alcohol.

Who should not get propofol?

You should not use propofol if you are allergic to it, or if you have: allergies to peanuts, eggs, egg products, soybeans or soy products.

Can propofol cause heart arrhythmia?

Though propofol can induce various types of arrhythmias, some of which are severe, the incidence of arrhythmia is relatively rare at clinically relevant concentrations of propofol. Numerous studies conclusively show that propofol has the potential to inhibit arrhythmia.

Do you stop breathing with propofol?

What side effects does propofol have? It can cause a decrease in blood pressure, it can depress or even stop breathing, and it can cause pain on injection.