Background and Goal of Study: Various sedative and analgesic medication has been used for shockwave lithotripsy (SWL). The aim of this study was to compare dexmedetomidine and propofol during SWL in terms of haemodynamic, analgesic and sedative effects.
Materials and Methods: After institutional review board approval and written patient permission had been obtained, 40 patient of ASA physical status I and II, ranging in age from 18 to 60 years, who were scheduled for elective SWL were studied. The patients were randomly divided into two groups of 20. In group I, sedation induction was done dexmedetomidine 6 μg kg−1. iv (infused in 10 mins) and infusion was started as 0.2 μg kg−1 h−1, whereas in groups II, induction was done with propofol 100 μg kg−1 iv (infused in 10 mins) and infusion was started as 40 μg kg−1 h−1. All the patients received fentanyl 1 μg kg−1 iv 10 minutes before SWL. Pain intensity was evaluated on a 0 to 100-mm visual analog scale (VAS). The level of sedation was determined using the Observer's Assessment of Alertnes/Sedation (OAS/S). The OAS/S was measured just before treatment, and the OAS/S and VAS were measured at the first minute and every 5 minutes. Hemodynamic and respiratory parameters were measured before SWL session, after sedation and during the SWL procedure at 5-minute intervals started at the first minute of SWL. Hemodynamic and respiratory parameters were evaluated post-SWL 45, 60, 90 and 120 minutes.
Results and Discussions: The two groups were similar with respect to demographic characteristics. There were no significant changes in inter-group mean blood pressure and heart rate, but respiratory rate was higher (except 120 minute) in the propofol group after treatment. O2 saturation values at 5 to 35 minutes were found to be significantly higher in group I. OAS/S and VAS values at 25 to 35 minutes were found to be significantly higher in group II.
Conclusion(s): Dexmedetomidine can be used during SWL and because of advantage of no loss of respiratory drive, good analgesia and sedation it may be a good alternative to propofol.