Comparative analysis of general anesthesia and ultrasound-guided intercostal nerve block in subcutaneous implantable cardioverter-defibrillator perioperative care
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND Subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation requires effective anesthesia. General anesthesia (GA) carries risks like hemodynamic instability, while ultrasound-guided intercostal nerve block (US-ICNB) may offer better pain control. This study hypothesized US-ICNB is superior in perioperative safety and pain management. AIM To compare perioperative outcomes of GA and US-ICNB in S-ICD implantation. METHODS This retrospective single-center study included 64 patients who received S-ICD implantation between February 2021 and December 2024. They were divided into GA and US-ICNB groups based on anesthesia type. Demographic data, perioperative parameters (operation time, pain scores, analgesic usage), and postoperative outcomes (complications, defibrillation events) were collected and analyzed. Statistical tests were used to compare the two groups. RESULTS This study included 64 patients (20 in the GA group and 44 in the US-ICNB group). Baseline left ventricular ejection fraction was significantly lower in the US-ICNB group (39.20% ± 12.00% vs 56.20% ± 11.50% in GA, P < 0.001), while American Society of Anesthesiologists scores and comorbidities were comparable. US-ICNB showed superior pain control, with significantly lower numeric rating scale scores at 6-48 hours (P < 0.001) and fewer patients requiring analgesics (P = 0.02). The US-ICNB group had shorter operation times (P < 0.001), total hospital stays (P < 0.001), and later first analgesia times (P < 0.001). No anesthesia-related complications occurred in either group. CONCLUSION Both anesthetic methods were safe in the short term. However, US-ICNB was superior in reducing operation and hospital stay times and alleviating peri-operative pain. It has high safety in S-ICD implantation and deserves further clinical promotion, though large-scale, multi-center, randomized controlled trials are needed to confirm these findings.
Source: World Journal of Cardiology
Authors: Chun-Jie Wen, Ji-Fang Cheng, Sheng-Bo Jiang, Meng Wang, Xiao-Xiao Yin, Rui Liu, Wen Shen, Ying Zhong
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415855133