A comparison of sedation with dexmedetomidine or propofol during shockwave lithotripsy: A Randomized controlled trial

被引:62
作者
Kaygusuz, Kenan [1 ]
Gokce, Gokhan [2 ]
Gursoy, Sinan [1 ]
Ayan, Semih [2 ]
Mimaroglu, Caner [1 ]
Gultekin, Yener [2 ]
机构
[1] Cumhuriyet Univ, Sch Med, Dept Anesthesiol, TR-58140 Sivas, Turkey
[2] Cumhuriyet Univ, Sch Med, Dept Urol, TR-58140 Sivas, Turkey
关键词
D O I
10.1213/01.ane.0000296453.75494.64
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
BACKGROUND: Dexmedetomidine, because it has both sedative and analgesic properties, may be suitable for conscious sedation during painful procedures. Extracor-Poreal shockwave lithotripsy (ESWL) is a minimal to mildly painful procedure that requires conscious sedation. We thus evaluated the utility of dexmedetomidine compared with propofol during an ESWL procedure. METHODS: Forty-six patients were randomly allocated into two groups to receive either dexmedetomidine or propofol for elective ESWL. Dexmedetomidine was infused at 6 mu g center dot kg(-1) center dot h(-1) for 10 min followed by an infusion rate of 0.2 mu g center dot kg(-1) center dot h(-1). Propofol was infused at 6 mg center dot kg(-1) center dot h(-1) for 10 min followed by an infusion of 2.4 mg center dot kg(-1) center dot h(-1). Fentanyl 1 mu g/kg IV was given to all patients 10 min before ESWL. Pain intensity was evaluated with a visual analog scale at 5-min intervals during ESWL (10-35 min). Sedation was determined using the Observer's Assessment of Alertness/Sedation. The Observer's Assessment of Alertness/ Sedation scores and hemodynamic and respiratory variables were recorded regularly during ESWL (35 min) and up to 85 min after. RESULTS: Forty patients were evaluated. Visual analog scale values with dexmedetomidine were significantly lower than those with propofol only at the 25-35 min assessments (P < 0.05). During sedation, the respiratory rate with dexmedetomidine was significantly slower but Spo(2) was significantly higher than with propofol (P < 0.05). Other clinical variables were similar (P > 0.05). CONCLUSION: A combination of dexmedetomidine with fentanyl can be used safely and effectively for sedation and analgesia during ESWL.
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页码:114 / 119
页数:6
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