Conscious Sedation with Local Anesthesia versus General Anesthesia for Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI)

Abstract

Background: Transcatheter Aortic Valve Implantation (TAVI) procedure is being performed under general anesthesia (GA), conscious sedation associated with local anesthesia (CSLA) and local anesthesia alone. There have been limited studies to determine which plan of anesthesia is associated with better results. Objective: We aimed in this study to assess the role of CSLA in outcome, complications, mortality and to assess quality of life in immediate post-procedural period (ICU and hospital stay). Patients and methods: This interventional clinical trial study was performed in Ain Shams University Hospitals. The sample size was 70 cases of Aortic Stenosis planned for TAVI, they were randomized into two groups: Group (GA) received general anesthesia and comprised 33 patients and were considered the control group, and Group (CSLA) received conscious sedation combined with LA and comprised 37 patients, five of them were switched to GA and were excluded from the study. Results: There was a significant difference between the two groups as regard Intraoperative MAP in which GA group showed decrease >20%. There was also highly significant difference in PaCO2 in which CSLA group showed higher levels. There was a significant difference in pH showing more acidosis in the CSLA group. However, there is no significant difference between the groups as regard intraoperative heart rate and PaO2. Conclusion: In the current study, the CSLA group showed more incidence