Anesthesia for extracorporeal shock wave lithotripsy: General anesthesia versus total intravenous anesthesia

ABSTRACT

This study compared propofol-based total intravenous anesthesia [T1VA] and sevoflurane-based general anesthesia [GA] for outpatients of ESWI. After receiving midazolam 2 mg i.v., 60 subjects were randomly assigned to one of two groups. In the TIVA group propofol 50-100 ug/kg/min. i.v. was titrated to maintain an observer's assessment of alertness/sedation score [OAA/S] of 2-3 [five awake to one asleep]. Fentanyl 0.1 ug/kg/min. supplemented with 0 5 ug/kg boluses i.v. was administered for pain control. In the GA group anesthesia was induced with propofol 1.5 mg/kg i.v. and fentanyl 1 mug/kg i.v. and maintained with sevoflurane titrated according to clinical signs and nitrous oxide 60%. In the GA group metoclopramide was administered as a prophylactic anti-emetic. Recovery times and postoperative side effects were assessed up to 12 hours after the procedure. The use of sevoflurane reduced the opioid requirements and episodes of desaturation and decreased disruptive movements during the procedure in addition to hemodynamic stability. Discharge times were similar in both groups