News: Conscious Sedation is Safe Alternative to General Anesthesia for TAVR

University of California, Los Angeles (UCLA) scientists have found that conscious sedation is a safe and viable option to general anesthesia for people undergoing transcatheter aortic valve replacement (TAVR). In the study, patients who underwent conscious sedation had a similar rate of adverse events to those who underwent anesthesia, but those who were given conscious sedation had shorter stays in the intensive care unit (30 versus 96 hours for those with general anesthesia) and shorter hospital stays (4.9 days versus 10.4 days). The direct costs for their care were 28 percent lower, and almost all other medical costs were lower as well. In both groups, 1.5 percent of patients died during hospitalization. 

Most medical centers perform the procedure under general anesthesia but some, including UCLA, now offer their patients conscious sedation. The study was the first to detail the cost differences and outcomes between conscious sedation and general anesthesia during TAVR. Researchers analyzed records of 196 adult patients who underwent TAVR at Ronald Reagan UCLA Medical Center between August 2012 and June 2016. The researchers write that a large-scale, controlled and randomized study should be conducted to validate their findings.

Based on the study, patients undergoing TAVR should receive conscious sedation instead of general anesthesia whenever possible. 

Reference

1. Toppen W, Johansen D, Sareh S, Fernandez J, Satou N, Patel KD, et al. Improved costs and outcomes with conscious sedation vs general anesthesia in TAVR patients: time to wake up? PLOS ONE, 2017; 12 (4): e0173777 DOI: 10.1371/journal.pone.0173777