Fast-tracking after immersion lithotripsy

General anesthesia versus monitored anesthesia care

Margarita Coloma, Jen W. Chiu, Paul F. White, W. Kendall Tongier, Larry L. Duffy, Steven C. Armbruster

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Both monitored anesthesia care (MAC) and general anesthesia (GA) offer advantages over epidural anesthesia for immersion lithotripsy. We compared propofol-based MAC and desflurane-based GA techniques for outpatient lithotripsy. After receiving midazolam 2 mg IV, 100 subjects were randomly assigned to one of two anesthetic treatment groups. In the MAC group, propofol 50-100 μg · kg-1 · min-1 IV was titrated to maintain an observer's assessment of alertness/sedation score of 2-3 (5 = awake/alert to 1 = asleep). Remifentanil 0.05 μg· kg-1 · min-1 IV supplemented with 0.125 μg/kg IV boluses, was administered for pain control. In the GA group, anesthesia was induced with propofol 1.5 mg/kg IV and remifentanil 0.125 μg/kg IV and maintained with desflurane (2%-4% inspired) and nitrous oxide (60%). Tachypnea (respiratory rate >20 breaths/min) was treated with remifentanil 0.125 μg/kg IV boluses. In the GA group, droperidol (0.625 mg IV) was administered as a prophylactic antiemetic. Recovery times and postoperative side effects were assessed up to 24 h after the procedure. Compared with MAC, the use of GA reduced the opioid requirement and decreased movements and episodes of desaturation (<90%) during the procedure. Although the GA group took longer to return to an observer's assessment of alertness/sedation score of 5, discharge times were similar in both groups. We conclude that GA can provide better conditions for outpatient immersion lithotripsy than MAC sedation without delaying discharge.

Original languageEnglish (US)
Pages (from-to)92-96
Number of pages5
JournalAnesthesia and Analgesia
Volume91
Issue number1
StatePublished - Jul 2000

Fingerprint

Lithotripsy
Immersion
General Anesthesia
Anesthesia
Propofol
Outpatients
Droperidol
Tachypnea
Antiemetics
Epidural Anesthesia
Midazolam
Nitrous Oxide
Respiratory Rate
Opioid Analgesics
Anesthetics
Pain
remifentanil

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Coloma, M., Chiu, J. W., White, P. F., Tongier, W. K., Duffy, L. L., & Armbruster, S. C. (2000). Fast-tracking after immersion lithotripsy: General anesthesia versus monitored anesthesia care. Anesthesia and Analgesia, 91(1), 92-96.

Fast-tracking after immersion lithotripsy : General anesthesia versus monitored anesthesia care. / Coloma, Margarita; Chiu, Jen W.; White, Paul F.; Tongier, W. Kendall; Duffy, Larry L.; Armbruster, Steven C.

In: Anesthesia and Analgesia, Vol. 91, No. 1, 07.2000, p. 92-96.

Research output: Contribution to journalArticle

Coloma, M, Chiu, JW, White, PF, Tongier, WK, Duffy, LL & Armbruster, SC 2000, 'Fast-tracking after immersion lithotripsy: General anesthesia versus monitored anesthesia care', Anesthesia and Analgesia, vol. 91, no. 1, pp. 92-96.
Coloma, Margarita ; Chiu, Jen W. ; White, Paul F. ; Tongier, W. Kendall ; Duffy, Larry L. ; Armbruster, Steven C. / Fast-tracking after immersion lithotripsy : General anesthesia versus monitored anesthesia care. In: Anesthesia and Analgesia. 2000 ; Vol. 91, No. 1. pp. 92-96.
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