title: Use of intravenous alfentanil-midazolam anesthesia for sedation during brief endourologic procedures.
abstract: Traditionally, general or regional anesthesia has been employed during endourologic procedures. The success of sedative-analgesic sedation during SWL prompted an investigation into its use in minor endourologic procedures. We compared intravenous alfentanil-midazolam anesthesia (n = 30) with spinal anesthesia (n = 35) during procedures such as ureteroscopy and stent placement using physiologic measures and patient and anesthetist ratings. The former series was prospective; the latter was retrospective. Physiologic measures remained stable and oxygen saturation was above 90% in all patients in both groups during the procedures. The average anesthesia and recovery room times were significantly shorter for patients given alfentanilmidazolam: 23.3 v 36.1 minutes and 85.5 v 179.6 minutes, respectively (P < 0.001; t-test), and this difference reduced the anesthesia cost an average of 46%. The anesthetists rated the intravenous regimen satisfactory in 92% of the patients, and 94% of the patients rated the procedure as comfortable. All 18 of the patients who had previously had spinal anesthesia considered alfentanil-midazolam superior. Intravenous alfentanil-midazolam sedation anesthesia can provide adequate analgesia for many minor endourologic procedures while shortening the anesthesia recovery time.
authors.affiliation: Department of Urology, Medical Center Hospital of Vermont, Burlington.
authors.forename: D A
authors.initials: DA
authors.lastname: Schow
authors.forename: T L
authors.initials: TL
authors.lastname: Jackson
authors.forename: J M
authors.initials: JM
authors.lastname: Samson
authors.forename: S A
authors.initials: SA
authors.lastname: Hightower
authors.forename: D L
authors.initials: DL
authors.lastname: Johnson
mesh_terms: D015760:Alfentanil / Q000009:adverse effects; D000771:Anesthesia, Intravenous; D000775:Anesthesia, Spinal; D006801:Humans; D008874:Midazolam / Q000009:adverse effects; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014572:Urology / Q000379:methods*
chemical_list: D015760:Alfentanil; D008874:Midazolam