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Related Experiment Videos

Anesthesiologist-controlled versus patient-controlled propofol sedation for shockwave lithotripsy.

Jamal A Alhashemi1, Abdullah M Kaki

  • 1Department of Anesthesia and Critical Care, King Abdulaziz University Hospital, P.O. Box 31648, Jeddah 21418, Saudi Arabia. jalhashemi@kau.edu.sa

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|April 26, 2006
PubMed
Summary

Anesthesiologist-controlled sedation (ACS) provided deeper sedation and greater comfort during extracorporeal shockwave lithotripsy but required more propofol and resulted in slower recovery compared to patient-controlled sedation (PCS).

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Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • Sedation is crucial for patient comfort during procedures like extracorporeal shockwave lithotripsy (ESWL).
  • Propofol and fentanyl are commonly used agents for procedural sedation.
  • Comparing anesthesiologist-controlled sedation (ACS) with patient-controlled sedation (PCS) can optimize sedation strategies.

Purpose of the Study:

  • To compare anesthesiologist-controlled sedation (ACS) versus patient-controlled sedation (PCS) for patients undergoing ESWL.
  • To evaluate differences in propofol requirements, sedation levels, and recovery times between ACS and PCS.

Main Methods:

  • A double-blind study randomized 64 patients undergoing ESWL to either ACS or PCS with propofol.
  • Sedation was monitored using the A-line ARX index; analgesia with the visual analogue scale.

Related Experiment Videos

  • Psychomotor recovery and discharge readiness were assessed using the Trieger dot test and postanesthesia discharge score.

    • Main Results:

    • Anesthesiologist-controlled sedation (ACS) group received more propofol (398 mg vs. 199 mg) and achieved deeper sedation (ARX index 35 vs. 73).
    • Patients in the ACS group experienced less pain (VAS 0 vs. 3) and reported higher satisfaction (median 7 vs. 6).
    • Patient-controlled sedation (PCS) group demonstrated faster psychomotor recovery (8 vs. 16 dots missed) and earlier discharge readiness (40 min vs. 88 min).

    Conclusions:

    • Anesthesiologist-controlled sedation (ACS) with propofol/fentanyl provides superior sedation and comfort for ESWL compared to PCS.
    • However, ACS is linked to increased propofol use and delayed recovery and discharge criteria achievement.
    • PCS facilitates quicker recovery and earlier discharge readiness in patients undergoing ESWL.