Propofol anesthesia in extracorporeal shock wave lithotripsy

Extracorporeal shock wave lithotripsy (ESWL) has been a successful method for variously localized urolithiasis. The aim of this study was to observe the respiratory and cardiovascular effects of intravenous propofol infusion and to show if it produces a satisfactory anesthesia as a single agent in ESWL The study was performed on 17 patients suffering from variously located urolithiasis. After premedication, induction of anesthesia was performed with 2.5 mg/kg propofol intravenously. Before and 1 minute after the induction; heart rate, systolic and diastolic blood pressure, end tidal car- bondioxide, capillary oxygen saturation values of the patients were measured and recorded. Anesthesia was maintained by the infusion of 0.2% propofol with changing rates of 14,12,10,8,4, 2 mg/kg/h in periods of 10 minutes in turn. In the first minute of every dose period the variables were measured. During the procedure, patients were inhaled 41t/min oxygen through a nasal cannula. Propofol infusion was stopped 5 minutes before the last shock wave. After recovery cardiovascular and respiratory functions were measured again. The results showed no significant difference between the values of respiratory rate, end tidal C02 and capillary 02 saturation at different measurements. Heart rate was significantly lower during induction (76.5113.5) and during infusion rates of 14mg/kg/h (82.519.9) and 2mg/kg/h (82.817.7) than the control values (84.2112.7) (p<0.05). In the measurements mean systolic arterial pressure were less than the control level. During the procedure there was not any requirement for an adjuvant analgesic agent. We conclude that; propofol can obtain sufficient analgesia during ESWL procedure and can be used safely on patients who do not have cardiovascular dysfunction.

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