Anesthesia and Perioperative Pain Management During Cardiac Electronic Device Implantation

Overview

Journal J Pain Res

Publisher Dove Medical Press

Date 2017 May 2

PMID 28458575

Citations 6

Authors

Marina Biocic

Dijana Vidosevic

Matija Boric

Teo Boric

Lovel Giunio

Damir Fabijanic

Livia Puljak

Affiliations

Soon will be listed here.

Abstract

Background: The degree of pain caused by the implantation of cardiac electronic devices (CEDs) and the type of anesthesia or perioperative pain management used with the procedure have been insufficiently studied. The aim of this study was to analyze perioperative pain management, as well as intensity and location of pain among patients undergoing implantation of CED, and to compare the practice with published guidelines.

Patients And Methods: This was a combined retrospective and prospective study conducted at the tertiary hospital, University Hospital Split, Croatia. The sample included 372 patients who underwent CED implantation. Perioperative pain management was analyzed retrospectively in 321 patients who underwent CED implantation during 2014. In a prospective study, intensity and location of pain before, during, and after the procedure were measured by using a numerical rating scale (NRS) ranging from 0 to 10 in 51 patients at the same institution from November 2014 to August 2015.

Results: A quarter of patients received analgesia or sedation before surgery. All the patients received local lidocaine anesthesia. After surgery, 31% of patients received pain medication or sedation. The highest pain intensity was observed during CED implantation with the highest NRS pain score being 8. Some patients reported severe pain (NRS >5) also at 1, 3, 6, 8, and 24 hours after surgery. The most common pain locations were surgical site, shoulder, and chest. Adherence to guidelines for acute perioperative pain management was insufficient.

Conclusion: Patients may experience severe pain during and after CED implantation. Perioperative pain management was suboptimal, and higher doses of sedation and intensive analgesia are required. Guidelines for acute perioperative pain management and anesthesia during CED implantation should be developed.

Citing Articles

Wide-awake local anesthesia during insertion of cardiac implantable electronic devices: a randomized study.

Doganozu E, Ilgin B Postepy Kardiol Interwencyjnej. 2025; 20(4):461-467.

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What is Known About Early Mobilisation After Cardiac Electronic Device Implant? A Scoping Review.

Caleffi D, Ferri P, Bellifemine M, Rovesti S, Valenti M Med Devices (Auckl). 2024; 17:513-524.

PMID: 39713794 PMC: 11660658. DOI: 10.2147/MDER.S493641.

Postoperative intravenous patient-controlled analgesia improves pain management after subcutaneous implantable defibrillator implantation.

Tsutsui K, Terazaki Y, Kanai R, Ishii M, Ohno S, Sasaki Y J Arrhythm. 2024; 40(2):349-355.

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Pain during cardiac implantable electronic device implantation.

Wilson D, Brewster N, Taylor R, Trevelyan A, Apostolakis M, Goyal D Br J Cardiol. 2022; 28(4):43.

PMID: 35747068 PMC: 9063704. DOI: 10.5837/bjc.2021.043.

Post-operative pain following cardiac implantable electronic device implantation: insights from the BRUISE CONTROL trials.

Nair G, Birnie D, Sumner G, Krahn A, Healey J, Nery P Europace. 2020; 23(5):748-756.

PMID: 33367623 PMC: 8139821. DOI: 10.1093/europace/euaa349.

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