title: Comparison of intravenous sedative-analgesic techniques for outpatient immersion lithotripsy.
abstract: Fifty-three unpremedicated outpatients undergoing elective extracorporeal shock wave lithotripsy using an unmodified Dornier HM-3 lithotriptor received one of two different intravenous sedation-analgesia techniques. Both intravenous midazolam-alfentanil and fentanyl-propofol techniques produced conditions comparable to those achieved with epidural anesthesia during immersion lithotripsy. Of the two sedative-analgesic techniques, midazolam-alfentanil was associated with greater intraoperative amnesia (81% vs 38%), whereas fentanyl-propofol produced less cardiorespiratory depression and fewer postoperative side effects (e.g., pruritus). Compared with a standard epidural anesthesia technique, the mean anesthesia and recovery times were significantly shorter with the two intravenous sedation-analgesia techniques (57-62 min vs 105 min and 143-147 min vs 199 min, respectively). These data suggest that combinations of either midazolam and alfentanil or fentanyl and propofol are viable alternatives to epidural anesthesia for outpatient immersion lithotripsy.
authors.affiliation: Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri 63110.
authors.forename: T G
authors.initials: TG
authors.lastname: Monk
authors.forename: B
authors.initials: B
authors.lastname: Bouré
authors.forename: P F
authors.initials: PF
authors.lastname: White
authors.forename: S
authors.initials: S
authors.lastname: Meretyk
authors.forename: R V
authors.initials: RV
authors.lastname: Clayman
mesh_terms: D000328:Adult; D015760:Alfentanil; D000556:Ambulatory Surgical Procedures; D000698:Analgesia; D000758:Anesthesia / Q000379:methods*; D000762:Anesthesia Recovery Period; D000767:Anesthesia, Epidural; D005260:Female; D005283:Fentanyl; D006439:Hemodynamics; D006801:Humans; D007262:Infusions, Intravenous; D007432:Intraoperative Period; D008096:Lithotripsy; D008297:Male; D008874:Midazolam; D008875:Middle Aged; D015742:Propofol
chemical_list: D015760:Alfentanil; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol