title: [Optimized analgesic sedation techniques for ESWL].
abstract: Analgo-sedation for ESWL treatment has been associated with a variety of problems. Minimal invasiveness of this technique should combine with haemodynamic stability as well as with adequate oxygenation. Patient acceptance has to be considered as another important aspect. Our study demonstrates the effectiveness of an analgosedative regimen with regard to these aspects. 50 ASA I-III patients scheduled for ESWL treatment were randomly allocated to receive either no premedication (n = 25) or chlorazepam as oral premedication (n = 25). The analgosedative technique was identical in both groups, consisting of atropine 0.25 mg, droperidol 5 mg (2.5 mg, if body weight less than 60 kg), and alfentanil 10 micrograms/kg intravenously. If necessary, repeated boluses of alfentanil 5 micrograms/kg were administered up to a maximum of 2 mg. Heart rates, arterial blood pressures, and peripheral oxygen saturation were measured during treatment. Post-treatment, patients were interviewed to assess the quality of analgesia. The results showed that our analgo-sedative regimen is suitable for ASA I-III patients. Stable heamodynamic conditions and adequate oxygenation were achieved in all patients. Patient acceptance was good. Patients with anxiolytic premedication benefited in terms of reduction in blood pressure and heart rate. The study also showed that anaesthesiologists may underestimate the pain intensity experienced and assessed by the patient.
authors.affiliation: Klinik für Anästhesiologie der Ruprecht-Karls-Universität Heidelberg.
authors.forename: K
authors.initials: K
authors.lastname: Stubbig
authors.forename: H
authors.initials: H
authors.lastname: Böhrer
authors.forename: H
authors.initials: H
authors.lastname: Bauer
authors.forename: G
authors.initials: G
authors.lastname: Jürs
mesh_terms: D000368:Aged; D015760:Alfentanil; D000698:Analgesia; D001285:Atropine; D003009:Clorazepate Dipotassium; D004329:Droperidol; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011229:Preanesthetic Medication
chemical_list: D015760:Alfentanil; D003009:Clorazepate Dipotassium; D001285:Atropine; D004329:Droperidol; D010100:Oxygen
vernacular_title: Optimiertes Analgosedierungs-Verfahren zur ESWL-Behandlung.