Fentanyl compared to buprenorphine for atrial fibrillation ablation analgesia and sedation: a retrospective cross-sectional study

BACKGROUND: The effects of general anesthesia with deep sedation and conscious sedation have been compared for sedation management in the perioperative period for radiofrequency catheter ablation of the heart to treat atrial fibrillation. However, there is no consensus as to which drug to use for conscious sedation. This study aimed to investigate analgesic and sedative drugs suitable for perioperative ablation. METHODS: We retrospectively examined 93 patients who underwent atrial fibrillation ablation at Kariya Toyoda General Hospital between December 2017 and April 2019 and investigated differences in the outcomes, such as depth of sedation and postoperative adverse events between the buprenorphine hydrochloride (n = 46) and fentanyl citrate (n = 47) groups. RESULTS: The depth of sedation was similar between the two groups, without significant between-group differences in postoperative vomiting. The number of additional injections of thiamylal sodium to manage discomfort and pain during ablation were significantly lower in the fentanyl group. Additionally, the cumulative area product, cumulative total air kerma, 1-year postoperative atrial fibrillation recurrence rate, and postoperative complications were not significantly different between the two groups. CONCLUSIONS: Although there were no significant differences in the efficacy or safety between buprenorphine hydrochloride and fentanyl citrate as analgesics used during atrial fibrillation ablation, intraoperative body movements and patient discomfort could be reduced to a greater extent with the use of fentanyl.