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Target-controlled Infusion of Propofol and Remifentanil for a

patient with Ablation of Atrial Fibrillation

Su-min Gao, Zheng-chao Yang, Ting-ting Wang, Shang-long Yao

Department of Anesthesiology and Intensive Care Medicine, Union Hospital, Tongji Medical College, Huazhong University
of Science and Technology, Wuhan 430000, China

Abstract

Objective. The choice of anesthesia, monitors, and anesthetic care for ablation of atrial fibrillation (AF) has not been
described clearly. This case report is to present an anesthesia technique for ablation of AF and to evaluate its efficacy and
safety of the anesthetics used.

Methods. This was a case report of a 50-year old female patient who was performed radiofrequency catheter ablation
of AF. Surgery was carried out under the total intravenous anesthesia (TIA) with a laryngeal mask airway (LMA) insertion,
which was performed by target-controlled infusion (TCI) of propofol and remifentanil. Under the procedure of anesthesia,
standard monitored measures were performed to ensure her safety.

Results. Surgery was carried out successfully under the TIA with TCI of propofol and remifentanil. The anesthesia
induction was fast and comfortable, smooth, recovery quickly after anesthesia, which did not cause any severe
complication.

Conclusion. TCI of propofol and remifentanil could provide the satisfactory efficacy and safety during ablation of AF.
Key Words: Total intravenous anesthesia; Target-controlled infusion; Propofol; Remifentanil; Ablation; Atrial fibrillation
Corresponding Author: Shang-long Yao, E-mail: ysltian@163.com

Introduction analgesia during catheter ablation of AF. Currently,
controversy surrounds the use of volatile agents during it.
Atrial fibrillation (AF) is the most common sustained Intravenous anesthetics, including propofol and opoids,
arrhythmia encountered in clinical practice, causing high are believed not to seriously affect the surgery compared
morbidity and mortality[1]. With an increasing number with volatile anesthetics[5]. In this case report, we present
of procedures worldwide, catheter ablation has become a patient with ablation of AF who was anesthetized
a mature treatment technique of AF[2]. Although the with propofol and remifentanil using a target-controlled
expectation of cure is excellent, the procedure is often technique for cardiac catheter ablation.
long, uncomfortable and painful for patients that must
remain motionless for hours. Moving during ablation of AF, Case report
it may be followed by disturbances of the Electro-anatomic
mapping systems[3], causing mapping and ablation This patient was a 50-year-old female, 160 cm in
inaccuracies as well as further increase in procedure height, and weighing 60 kg with a past medical history
duration. The ablation procedure of AF may be painful, so of hypertension for 5 years. She denied other systematic
it is commonly performed under sedation and analgesia. disease such as diabetic mellitus, and liver disease and
After sufficient sedation and analgesia, it allows complete so on. She had never undergone any operation and taken
patient immobilization which plays a significant role in the any allergic things. She denied any abuse of alcohol and
success of mapping and ablation[4]. tobacco. The patient was performed for radiofrequency
catheter ablation of AF under total intravenous anesthesia
Both inhalational anesthesia and intravenous (TIA). Subsequently, a 16G catheter and a 20G catheter
anesthesia has been used to provide sedation and

Laboratory and Clinical CInavseestRigeaptoiortn 69 FAM 2014 Jan/Feb Vol.21 Issue 1
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