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document
Total intravenous anesthesia using remifentanil in extracorporeal shock wave lithotripsy ( ESWL ) . Comparison of two dosages : a randomized clinical trial . BACKGROUND Extracorporeal Shock Wave Lithotripsy is usually performed in day surgery setting , consequently people who undergo to this procedure need a safe and fast recovery . Conscious sedation with remifentanil can relieve from pain and keep patients in touch with anaesthesiologists . Few publications tell about infusion rates administered to perform this procedure7 . The aim of this study is to assess which is the most appropriate infusion rate . METHODS Patients were randomly assigned to two groups . Two different infusion rates were compared : 0,05 mcg/kg/min , GROUP A ( N.=114 ) , vs. 0.1 µg/kg/min , GROUP B ( N.=114 ) . Patients ' vital signs , additional analgesic requests , PONV ( postoperative nausea and vomiting ) and other side effects were registered . The deepness of sedation and patient 's satisfaction were evaluated referring to Obsever 's Assessment of Alertness and Sedation scale ( O/ASS ) and using a Likert 's scale respectively . Pain intensity was assessed with a 11-points VAS ( visual analogue scale ) . Differences between groups were analyzed using Student t test for independent variables . The χ2 test was used to analyze categorical variables . RESULTS The study enrolled 228 patients and assigned them to two groups ( N.=114 ) . No significant differences were found regarding Likert 's scale values ( P=0.20 ) , additional analgesic request ( P=0.30 ) and mean VAS values ( P > 0.05 ) between the two groups . The difference between the two groups about PONV , hypotension , oxygen desaturation and respiratory depression was statistically significant ( P < 0.05 ) , as a matter of fact in group A these side effects occurred less frequently . The fifth degree of O/ASS was estimated in about 1.61±0.19 min and 2.987±0.20 min in group A and in group B respectively ( P < 0.05 ) . CONCLUSION According with previous results remifentanil at the infusion rate of 0.05 µg/kg/min provides an effective analgesia , causing a lower incidence of side effect than 0.1 µg/kg/min , granting a fast and safe recovery .
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Intervention_Pharmacological
remifentanil
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Intervention_Physical
extracorporeal shock wave lithotripsy ( ESWL ) .
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Intervention_Physical
Extracorporeal Shock Wave Lithotripsy
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Intervention_Pharmacological
remifentanil
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Outcome_Physical
Patients ' vital signs
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Outcome_Other
additional analgesic requests
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Outcome_Physical
PONV ( postoperative nausea and vomiting
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Outcome_Physical
Obsever 's Assessment of Alertness and Sedation scale
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Outcome_Pain
Pain intensity
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Outcome_Other
regarding Likert 's scale values
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Outcome_Other
mean VAS values
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Outcome_Physical
about PONV
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Outcome_Physical
hypotension , oxygen desaturation and respiratory depression
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Outcome_Physical
The fifth degree of O/ASS
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Participant_Condition
extracorporeal shock wave lithotripsy ( ESWL ) .
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Participant_Sample-size
228