334 Pain management during atrial fibrillation ablation by the nurses

BackgroundRadiofrequency Atrial Fibrillation (AF) ablation is now currently performed. It is sometimes long, complex and painful when not made under general anaesthesia.ObjectiveTo determine the optimal management of pain during AF ablation procedures, by bringing back the analgesic practices of centers realizing this procedure in France.MethodNational survey realized by means of a questionnaire containing several items related to analgesia and addressed by mail way in 54 major french centers performing AF ablation.Results30 on 54 centres answered the questionnaire. In seventeen centers AF ablation is performed under general anaesthesia, in five centers under morphinomimetic (for exemple alfentanyl) +/- sédation (midazolam) taken care by an anaesthetic team (4 centers on 5 are satisfied), in eight centers under analgesia with morphine or nalbuphine +/- sédation (midazolam) taken care by nurses not specialized in anesthesia (4 centers are satisfied, 3 unsatisfied and 1 fairly satisfied there).ConclusionPain management differs according to centers but is made according to 3 main different methods. The analgesia with morphinomimetic +/-sédation taken care with an anaesthetic team seems to be an interesting alternative to the general anaesthesia while analgesia with only morphine or nalbuphine +/- sedation taken care by nurses not specialized in anesthesia is quite unsatisfactory in many cases. Based on this results, a new protocol of analgesia must be settled and will be assessed in the next months