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Chapter 3
closures, 1 restless patient) (Figure 1). In 3 patients femoral access was surgically achieved
under local analgesia (Table 1).
Premedication was administered in 76% of the patients and included temazepam 10 mg
(n=33), lorazepam 1 mg (n=40), midazolam 2.5–7.5 mg (n=63), and paracetamol 1000
mg (n=144) (Table 2). Procedural medication for conscious analgo-sedation included
remifentanil, alfentanil, sufentanil, propofol, morphine, and esketamine. 66% of the patients
received low dosages of opioids and 34% received sedative medication. Longer mean
procedure duration, i.e. catheterisation lab time, was observed with conscious sedation
(100 vs. 85 min p=0.008). There were no other differences in baseline characteristics
(Table 3) or outcome (Table 4) - including delirium - between patients receiving conscious
sedation or only LA. Procedural haemodynamic stability was achieved with small dosages
of catecholamines (norepinephrine, phenylephrine, atropine sulphate, ephedrine) in 37%
(n=65) of the patients.
30-day mortality was 5% (n=9) and immediate procedural mortality 1% (n=2). At 30 days
NYHA functional class had decreased from 3±0.6 to 1±0.9 (p=0.04). Mean total hospital stay
was 10 ± 8 days.
The rate of major bleeding was 17%. Stroke/TIA occurred in 6% of the patients. During total
hospital admission only 9 patients (5%) developed a delirium that was treated with haldol.
Figure 1.
Flowchart of the study population