Use of patient-controlled analgesia with alfentanil for extracorporeal shock wave lithotripsy

Kortis, Howard I.; Amory, David W.; Wagner, Bertil K.J.; Levin, Renee B.; Wilson, Earl R.; Levin, A. A.; Pitchford, Douglas E.; Pollak, Phyllis

doi:10.1016/0952-8180(95)90054-3

Cited by 7 publications

(8 citation statements)

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“…During intra-operative monitored anaesthesia care, PCS is known to be comparable with conventional anaesthesiologist-controlled sedation with continuous infusion of sedative drugs, but with lesser drug administration, a lighter sedation level and a shorter time to meet discharge criteria (17,18). The lighter sedation level is favourable in cataract surgery where full patient cooperation is mandatory and involuntary patient movement could be detrimental.…”

Section: Discussionmentioning

confidence: 98%

Patient-controlled sedation vs. anaesthetic nurse-controlled sedation for cataract surgery in elderly patients

Yun

Kim³

et al. 2007

International Journal of Clinical Practice

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Section: Discussionmentioning

confidence: 98%

Patient-controlled sedation vs. anaesthetic nurse-controlled sedation for cataract surgery in elderly patients

Yun

Kim³

et al. 2007

International Journal of Clinical Practice

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“…As the anesthesiologist was blinded to the A-line™ readings, these findings document the potential to sedate beyond patient requirements. Kortis et al 12 recently demonstrated that patientcontrolled analgesia is associated with a 31% reduction in alfentanil administration when compared with physician-controlled analgesia amongst patients undergoing ESWL. 12 In our study, it is unlikely that differences were due to the fact that patients in the PCS group were unable to augment their sedation.…”

Section: Discussionmentioning

confidence: 99%

“…Résultats : Comparés aux patients du groupe SCP, ceux du groupe SCA ont reçu plus de propofol (398 ± 162 mg vs 199 ± 68 mg, P < 0,001), et plus de sédatifs (index A-line ARX : 35 ± 16 vs 73 ± 16, P < 0,001), éprouvé moins de douleur (EVA : 0 ± 0 vs 3 ± 1, P < 0,001) et ont été plus satisfaits (médiane [Q1, Q3] : 7 [7,7] vs 6 [6,7], P < 0,001). Par ailleurs, les patients du groupe SCP ont connu une récupération psychomotrice plus rapide (mé-diane du Trieger dot test [Q1, Q3] : 8 [4,16] vs 16 [12,26] points manqués, P = 0,002) et ont atteint les critères de sortie de la salle de réveil ≥ 9 plus tôt (médiane [Q1, Q3] : 40 [35,60] vs 88 [75,100] min, P < 0,001).…”

Section: Tout Au Long De L'intervention La Sédation Et L'analgésie Ounclassified

Anesthesiologist-controlled versus patient-controlled propofol sedation for shockwave lithotripsy

Alhashemi

Kaki

2006

Can J Anesth/J Can Anesth

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“…The analgesic techniques most frequently used at the present time, range from sedation and intravenous opioid analgesia [14], and epidural analgesia alone or in combination with intravenous opioids [15,16] to patient-controlled analgesia whereby the patient self-administers analgesics through intravenous [17,18] or spinal infusion [19]. Obviously, hemoglobulin oxygen saturation and heart rate need to be monitored as they could become altered during ESWL due to adverse effects of the drugs or vagal reactions due to pain [20].…”

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confidence: 99%

Factors Determining Analgesic and Sedative Drug Requirements during Extracorporeal Shock Wave Lithotripsy

Salinas¹,

Lorenzo-Romero²,

Segura³

et al. 1999

Urol Int

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Purpose: The aim of this study was to determine what factors influence the analgesic and sedative requirements during extracorporeal shock wave lithotripsy (ESWL). Materials and Methods: A retrospective study was carried out on 2,103 lithotripsy treatments performed over a 7-year period using an electromagnetic lithotriptor. Treatment with analgesics and anxiolytic drugs administered during ESWL was evaluated, and two new variables to determine the analgesic and sedative requirements were defined. A multivariant analysis model was established to determine which variables are related to or could predict the analgesic and/or sedative drug requirements. Results: The most frequently used sedative drug was potassium chlorazepate which was used in 2,059 patients at a mean total dose of 25.6 mg. Pethidine was used in 2,006 patients at a mean total dose of 56.3 mg, and fentanyl in 995 patients at a dose of 93.3 μg. In 52.4% of patients analgesic requirements were low, and in 76.6% sedative requirements were low. In 21.1% of patients analgesic drug requirements were high, and in 1.8% of patients sedative drug requirements were high. The multivariant analysis showed that those requiring most analgesics were, the younger patients (p = 0.003), those who received a higher number of shock waves (p < 0.001) and those who needed more sedation (p < 0.001). Those who received the greatest amount of sedatives were women (p = 0.0026); younger patients (p < 0.001); those treated with higher voltages (p = 0.032), and patients with the highest analgesic requirements (p < 0.001). Conclusions: Predicting the analgesic drug requirements prior to ESWL is very difficult. The present study shows that young age, a greater discharge of shock waves and a high sedative drug requirement are factors clearly related to greater analgesic drug requirements. Higher sedative drug requirements are needed by women, younger patients, those receiving high discharge voltages and those with higher analgesic requirements.

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Use of patient-controlled analgesia with alfentanil for extracorporeal shock wave lithotripsy

Cited by 7 publications

References 0 publications

Patient-controlled sedation vs. anaesthetic nurse-controlled sedation for cataract surgery in elderly patients

Patient-controlled sedation vs. anaesthetic nurse-controlled sedation for cataract surgery in elderly patients

Anesthesiologist-controlled versus patient-controlled propofol sedation for shockwave lithotripsy

Factors Determining Analgesic and Sedative Drug Requirements during Extracorporeal Shock Wave Lithotripsy

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