title: A comparison of sedation with dexmedetomidine or propofol during shockwave lithotripsy: a randomized controlled trial.
abstract: BACKGROUND
  Dexmedetomidine, because it has both sedative and analgesic properties, may be suitable for conscious sedation during painful procedures. Extracorporeal 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 microg x kg(-1) x h(-1) for 10 min followed by an infusion rate of 0.2 microg x kg(-1) x h(-1). Propofol was infused at 6 mg x kg(-1) x h(-1) for 10 min followed by an infusion of 2.4 mg x kg(-1) x h(-1). Fentanyl 1 microg/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 Spo2 was significantly higher than with propofol (P < 0.05). Other clinical variables were similar (P > 0.05).
  
  
  CONCLUSIONS
  A combination of dexmedetomidine with fentanyl can be used safely and effectively for sedation and analgesia during ESWL.
authors.affiliation: Department of Anesthesiology, Cumhuriyet University School of Medicine, Sivas, Turkey. kaygusuz@cumhuriyet.edu.tr
authors.forename: Kenan
authors.initials: K
authors.lastname: Kaygusuz
authors.forename: Gokhan
authors.initials: G
authors.lastname: Gokce
authors.forename: Sinan
authors.initials: S
authors.lastname: Gursoy
authors.forename: Semih
authors.initials: S
authors.lastname: Ayan
authors.forename: Caner
authors.initials: C
authors.lastname: Mimaroglu
authors.forename: Yener
authors.initials: Y
authors.lastname: Gultekin
mesh_terms: D000328:Adult; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D016292:Procedural Sedation; D003243:Consciousness / Q000187:drug effects*; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015656:Respiratory Mechanics / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D005283:Fentanyl; D015742:Propofol