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Anesth Analg 2008; 106:114-119
© 2008 International Anesthesia Research Society
doi: 10.1213/01.ane.0000296453.75494.64
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AMBULATORY ANESTHESIOLOGY

A Comparison of Sedation with Dexmedetomidine or Propofol During Shockwave Lithotripsy: A Randomized Controlled Trial

Kenan Kaygusuz, MD*, Gokhan Gokce, MD{dagger}, Sinan Gursoy, MD*, Semih Ayan, MD{dagger}, Caner Mimaroglu, MD*, and Yener Gultekin, MD{dagger}

From the Departments of *Anesthesiology and {dagger}Urology, Cumhuriyet University School of Medicine, Sivas, Turkey.

Address correspondence and reprint requests to Dr. Kenan Kaygusuz, Department of Anesthesiology, Cumhuriyet University School of Medicine, 58140 Sivas, Turkey. Address e-mail to kaygusuz{at}cumhuriyet.edu.tr.

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 µg · kg–1 · h–1 for 10 min followed by an infusion rate of 0.2 µg · kg–1 · h–1. Propofol was infused at 6 mg · kg–1 · h–1 for 10 min followed by an infusion of 2.4 mg · kg–1 · h–1. Fentanyl 1 µg/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).

CONCLUSION: A combination of dexmedetomidine with fentanyl can be used safely and effectively for sedation and analgesia during ESWL.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.