Dexmedetomidine causes prolonged recovery when compared with midazolam/fentanyl combination in outpatient shock wave lithotripsy.
OBJECTIVE
Analgesia and sedation are usually required during extracorporeal shock wave lithotripsy. In the present study, the recovery time and effectiveness of sedation and analgesia of dexmedetomidine was compared with a midazolam/fentanyl combination in outpatient extracorporeal shock wave lithotripsy.


METHODS
Forty-nine patients scheduled for outpatient extracorporeal shock wave lithotripsy were randomly assigned to two groups: a dex group (n = 25; dexmedetomidine 1 microg kg(-1) loading dose followed by dexmedetomidine 0.2 microg kg(-1) h(-1) and a control group (n = 24; midazolam 0.05 mg kg(-1) and fentanyl 1 microg kg(-1)). Recovery time, rescue analgesics (fentanyl 25 microg) and sedatives (midazolam 1 mg), and patients' satisfaction rates were recorded.


RESULTS
The two groups were similar regarding patient characteristics and procedure-related details (P > 0.05). Recovery time was significantly prolonged in the dex group when compared with the control group (116.4 +/- 39.3 vs. 50.8 +/- 19.8 min, respectively, P < 0.001). The percentage of patients requiring rescue doses of fentanyl and the applied doses were significantly higher in the dex group than in the control group (96% vs. 67%, P = 0.01; and 69.0 +/- 31.7 vs. 38.8 +/- 42.9 microg, respectively, P = 0.007). More patients in the dex group received rescue midazolam (96% vs. 58%, P = 0.002). More patients in the control group were highly satisfied with their sedation/analgesia (83% vs. 56%, P = 0.038).


CONCLUSIONS
Dexmedetomidine was associated with a longer recovery time than a midazolam/fentanyl combination when used for sedation and analgesia during outpatient extracorporeal shock wave lithotripsy in this study. The incidence of rescue sedative and analgesic need was also significantly higher when dexmedetomidine was used.
Baskent University Faculty of Medicine, Department of Anaesthesiology, Ankara, Turkey.
P
P
Zeyneloglu
A
A
Pirat
S
S
Candan
S
S
Kuyumcu
I
I
Tekin
G
G
Arslan
D000553:Ambulatory Care / Q000379:methods; D000762:Anesthesia Recovery Period; D019162:Anesthetics, Combined / Q000009:adverse effects*; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D020927:Dexmedetomidine / Q000009:adverse effects*; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008096:Lithotripsy / Q000379:methods; D008297:Male; D008874:Midazolam / Q000009:adverse effects; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D012119:Respiration / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D020927:Dexmedetomidine; D008874:Midazolam; D010100:Oxygen; D005283:Fentanyl