Wen CJ, Cheng JF, Jiang SB, Wang M, Yin XX, Liu R, Shen W, Zhong Y. Comparative analysis of general anesthesia and ultrasound-guided intercostal nerve block in subcutaneous implantable cardioverter-defibrillator perioperative care. World J Cardiol 2025; 17(10): 110900 [DOI: 10.4330/wjc.v17.i10.110900]
Corresponding Author of This Article
Ying Zhong, MD, Endoscopy Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou 310009, Zhejiang Province, China. yingzhongyingong@163.com
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Cardiac & Cardiovascular Systems
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Oct 26, 2025 (publication date) through Oct 27, 2025
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World Journal of Cardiology
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1949-8462
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Wen CJ, Cheng JF, Jiang SB, Wang M, Yin XX, Liu R, Shen W, Zhong Y. Comparative analysis of general anesthesia and ultrasound-guided intercostal nerve block in subcutaneous implantable cardioverter-defibrillator perioperative care. World J Cardiol 2025; 17(10): 110900 [DOI: 10.4330/wjc.v17.i10.110900]
World J Cardiol. Oct 26, 2025; 17(10): 110900 Published online Oct 26, 2025. doi: 10.4330/wjc.v17.i10.110900
Comparative analysis of general anesthesia and ultrasound-guided intercostal nerve block in subcutaneous implantable cardioverter-defibrillator perioperative care
Chun-Jie Wen, Ji-Fang Cheng, Sheng-Bo Jiang, Meng Wang, Xiao-Xiao Yin, Rui Liu, Wen Shen, Cardiovascular Intervention Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Ying Zhong, Endoscopy Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Author contributions: Wen CJ proposed the research idea and designed the research method; Jiang SB and Liu R collected, managed, and processed the data; Yin XX performed the statistical analysis; Cheng JF conducted the research; Shen W prepared the first draft of the manuscript; Wang M helped revise and improve the manuscript; Zhong Y directed the research and supervised the team; all authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine (2025-0621).
Informed consent statement: This is a retrospective study and the Informed Consent Statement is not applicable.
Conflict-of-interest statement: The authors declared that they have no conflicts of interest regarding this work.
Data sharing statement: The datasets used and analysed during the current study available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying Zhong, MD, Endoscopy Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou 310009, Zhejiang Province, China. yingzhongyingong@163.com
Received: June 18, 2025 Revised: August 7, 2025 Accepted: September 23, 2025 Published online: October 26, 2025 Processing time: 128 Days and 18.1 Hours
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.
Core Tip: This study compares general anesthesia and ultrasound-guided intercostal nerve block in perioperative subcutaneous implantable cardioverter-defibrillator placement, evaluating their effects on pain management, recovery, and complications.
