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.