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Propofol and alfentanil sedation for extracorporeal shock wave lithotripsy

BACKGROUND AND OBJECTIVES: This non comparative study aimed at investigating optimal propofol and alfentanil doses used for sedation during extracorporeal shock wave lithotripsy (ESWL) as well as the time elapsed for hospital discharge. METHODS: Participated in this study 24 consecutive outpatients of both genders, physical status ASA I or II, submitted to ESWL under intravenous sedation. Sedation consisted of propofol (initial dose of 1 mg.kg-1 followed by continuous infusion with variable speed), and alfentanil (initial dose of 15 µg.kg-1 followed by additional 5 µg.kg-1 boluses according to clinical needs). Non invasive SpO2, SBP, DBP, and HR were monitored, and hospital discharge was provided according to Kortilla’s criteria for outpatient surgeries. RESULTS: Mean procedure duration was 46.8 ± 12.8 minutes. Mean total propofol and alfentanil doses were 59.0 ± 17.9 µg.kg-1.min-1 and 0.38 ± 0.14 µg.kg-1.min-1, respectively. Time for hospital discharge was 60 min or less in 58.3% of patients; 61 to 90 minutes in 20.9%; 91 to 120 minutes in 12.5%; and more than 120 minutes in 8.3%. There has been at least one episode of low arterial blood saturation (SpO2 £ 85%) in 45.8% of patients followed by quick reversion after 100% oxygen supply. CONCLUSIONS: Propofol and alfentanil in the doses reported are practical, effective, and safe for ESWL anesthesia, provided respiratory and cardiovascular parameters are monitored and devices for treating complications are readily avaiable.

DIAGNOSIS AND THERAPEUTIC PROCEDURES; HYPNOTICS; SEDATION


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