CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Irwin, M. G.
Right arrow Articles by Yang, J. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Irwin, M. G.
Right arrow Articles by Yang, J. C.

Canadian Journal of Anesthesia, Vol 43, 919-924, Copyright © 1996 by Canadian Anesthesiologists' Society

ARTICLES

Patient maintained alfentanil target-controlled infusion for analgesia during extracorporeal shock wave lithotripsy

MG Irwin, RC Campbell, TS Lun and JC Yang
Department of Anaesthesiology, Queen Mary Hospital, Hong Kong.

PURPOSE: The purpose of this study was to determine whether alfentanil given by a pharmacokinetic-based target controlled infusion (TCI) system under patient control is a suitable analgesic technique for extracorporeal shock wave lithotripsy (ESWL). METHODS: The design was an open, unblinded, noncomparative, prospective study. Forty outpatients undergoing ESWL were given patient maintained alfentanil TCI. Pain, nausea and sedation were assessed every 300 shocks. Vital signs were recorded every three minutes, pulse oximetry and electrocardiography being monitored continuously. Blood alfentanil concentration was measured for comparison with the predicted value. RESULTS: Alfentanil consumption (median 1.34 mg, range 0.8-3.6) and measured levels following treatment (median 60 ng.ml-1, range 15.6-134.3) varied widely. The precision of the TCI system and the median prediction error (bias) were both 49%. The median of pain scores recorded during treatment was 4 (range 0-8). The median respiration rate was 15 bpm (range 10-23), three patients required oxygen (SaO2 < 92%) cardiovascular measurements were stable and there was no excessive sedation. The incidence of nausea was 15%. All patients were ready for hospital discharge within one hour following treatment. CONCLUSIONS: Patient maintained alfentanil TCI provides good analgesia for ESWL in the majority of patients with little sedation. Respiratory depression is uncommon but supplementary oxygen should be given prophylactically. There is considerable interindividual variation in demand for alfentanil indicating the usefulness of the patient control method. The TCI system underestimated alfentanil blood concentrations but this did not affect its clinical usefulness.


This article has been cited by other articles:


Home page
 Canadian J. AnesthesiaHome page
J. A. Alhashemi and A. M. Kaki
Dexmedetomidine in combination with morphine PCA provides superior analgesia for shockwave lithotripsy: [La dexmedetomidine combinee a la morphine en AAC fournit une analgesie superieure pour la lithotripsie par ondes de choc]
Can J Anesth, April 1, 2004; 51(4): 342 - 347.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
H. S. Joo, W. J. Perks, M. T. Kataoka, L. Errett, K. Pace, and R. J. Honey
A Comparison of Patient-Controlled Sedation Using Either Remifentanil or Remifentanil-Propofol for Shock Wave Lithotripsy
Anesth. Analg., November 1, 2001; 93(5): 1227 - 1232.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1996 by the Canadian Anesthesiologists' Society.