Study on preoperative treatment of acute Type-A aortic dissection with endotracheal intubation combined with deep analgesia and sedation

  • Luo Chaoen
  • Asfandyar Khan
  • Hu Fan
  • He Shuangxi
  • Liu Qiaoling
  • Zhengwen Lei
Keywords: type A aortic dissection, SAS (Ricker Sedation- agitation scale), VAS (visual analogue score), Acute Stanford Type-A Aortic Dissection, Tracheal Intubation, Deep Analgesia and Sedation, Prevent Rupture

Abstract

Objectives: To investigate the efficacy and safety of endotracheal intubation combined with deep analgesia and sedation in the prevention of preoperative dissection rupture in acute Standford type A aortic dissection.

Methods: This study evaluated the impact of preoperative endotracheal intubation combined with deep analgesia and sedation on acute Stanford Type-A aortic dissection. Conducted at the First Affiliated Hospital of the University of South China’s cardiac intensive care unit from June 2018 to December 2021, 134 diagnosed patients participated. They were divided into experimental (n=42) and control (n=92) groups. Data collected included clinical details, biochemical markers, VAS and SAS scores, and preoperative dissection rupture occurrences. Criteria involved acute Stanford Type-A aortic dissection diagnosis and complete data. Exclusions encompassed rupture, vital sign instability after vasoactive drugs, or prolonged coma. Standardized methods were used for sample collection and analysis. The study’s design, duration, and location ensured comprehensive evaluation of the intervention’s effects on patients.

Results: The experimental group showed significantly fewer deaths due to dissection rupture compared to the control group (P < 0.05). Initial VAS and SAS scores (T0) were similar between groups (P > 0.05), indicating good comparability. However, at T1, T2, and T3, analgesia and sedation were significantly better in the experimental group (P < 0.05). By T4, patient numbers were too low in both groups for a significant difference (P > 0.05).

Conclusion: Preoperative endotracheal intubation combined with deep analgesia and sedation in patients with acute Stanford Type-A aortic dissection can produce good analgesic and sedative effects, effectively reduce the incidence of preoperative dissection rupture, and create conditions for subsequent surgical treatment of patients.

doi: https://doi.org/10.12669/pjms.40.1.8107

How to cite this: Chaoen L, Khan A, Fan H, Shuangxi H, Qiaoling L, Lei Z. Study on preoperative treatment of acute Type-A aortic dissection with endotracheal intubation combined with deep analgesia and sedation. Pak J Med Sci. 2024;40(1):46-54. doi: https://doi.org/10.12669/pjms.40.1.8107

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2023-11-15
How to Cite
Chaoen, L., Khan, A., Fan, H., Shuangxi, H., Qiaoling, L., & Lei, Z. (2023). Study on preoperative treatment of acute Type-A aortic dissection with endotracheal intubation combined with deep analgesia and sedation. Pakistan Journal of Medical Sciences, 40(1). https://doi.org/10.12669/pjms.40.1.8107