ABSTRACT

Anaesthesia during ekstracorporeal shock wave lithothripsy (ESWL) should be both short acting and safe, and also must perform enough analgesia and sedation during the procedure. In this study remifentanil has been compared with propofol-meperidin combination during ESWL.

After Hospital Education Planning Commitee approval, 50 patients were randomly assigned to recieve either propofol-meperidin or remifentanil for ESWL. Meperidin 1 mg.kg-1 was given to propofolmeperidin group (n=25) intramuscularly 30 minutes prior to procedure. 1 mg.kg-1.hr-1 propofol infusion was given with Patient Controlled Sedation (PCS) machine during the procedure. In the remifentanil group (n=25), 0.04 mcg.kg-1. min-1 remifentanil infusion was given with PCS machine during the procedure. All patients were monitored with SpO2, noninvazive blood pressure and ECG. Then 4 L.min-1 O2 was given via face mask. When they needed additional analgesic, the PCS machine was programmed to deliver 5 mg of propofol bolus for propofolmeperidin group and 10 mcg remifentanil bolus for remifentanil group. They were evaluated with Ramsey Sedation Score during the procedure and with Modified Alderate Score after the procedure.

The VAS scores were lower in the remifentanil group during and after the procedure (p<0.05) . The sedation scores were higher in the propofol group during and after procedure (p<0.05). Arterial tension values were lower in the propofol-meperidin group than the remifentanil group (p<0.05). Modified Alderate Scores were higher during 5th and 15th minutes after the procedure in the remifentanil group (p <0.05).

Both of the methods can provide enough sedation and analgesia during ESWL.