a1 Baskent University Faculty of Medicine, Department of Anaesthesiology, Ankara, Turkey
a2 Baskent University Faculty of Medicine, Department of Urology, Ankara, Turkey
Background and objectives 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 μg kg−1 loading dose followed by dexmedetomidine 0.2 μg kg−1 h−1) and a control group (n = 24; midazolam 0.05 mg kg−1 and fentanyl 1 μg kg−1). Recovery time, rescue analgesics (fentanyl 25 μg) 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 μg, 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).
Conclusion 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.
(Accepted April 25 2008)
c1 Correspondence to: Arash Pirat, Anesteziyoloji Anabilim Dalı, Başkent Üniversitesi Hastanesi, 10. Sok. No. 45 Bahçelievler, 06490 Ankara, Turkey. E-mail: firstname.lastname@example.org; Tel: +90 312 212 68 68/1069; Fax: +90 312 223 73 33