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Comparison of propofol/fentanyl and ketamine anesthesia in children during extracorporeal shockwave lithotripsy

I Aydin Erden1, Feyzi Artukoglu, Ahmet Gozacan

  • 1Department of Anesthesiology and Reanimation, Faculty of Medicine, Hacettepe University, Sihhiye 06100, Ankara, Turkey. aydinerden@yahoo.com

Saudi Medical Journal
|March 6, 2007
PubMed

Insights

Two anesthesia methods for pediatric Extracorporeal Shockwave Lithotripsy (ESWL) showed similar efficacy but different side effect profiles. Ketamine (Group K) had longer recovery and more post-procedure complications, while propofol/fentanyl (Group PF) had more intra-procedure complications.

Area of Science:

  • Pediatric Anesthesiology
  • Urology
  • Pain Management

Background:

  • Extracorporeal Shockwave Lithotripsy (ESWL) is a common treatment for pediatric upper urinary system stones.
  • Adequate sedation and analgesia are crucial for managing procedural pain in children undergoing ESWL.
  • Comparing anesthetic techniques is essential for optimizing pediatric ESWL outcomes.

Purpose of the Study:

  • To compare the efficacy and safety of two intravenous anesthesia protocols in pediatric patients undergoing ESWL.
  • To evaluate procedural, recovery, and discharge times associated with each anesthetic method.
  • To assess the incidence of intra- and post-procedural complications for each group.

Main Methods:

  • Forty pediatric patients (3 months-15 years) with upper urinary system calculi were randomized into two groups.
  • All patients received intranasal midazolam premedication.
  • Group K received intravenous ketamine; Group PF received intravenous propofol and fentanyl, with a propofol infusion.

Main Results:

  • Demographics, procedural, and discharge times were comparable between the ketamine (Group K) and propofol/fentanyl (Group PF) groups.
  • Group K experienced longer recovery times and higher post-procedural complication rates.
  • Group PF showed a higher incidence of intra-procedural complications.

Conclusions:

  • Both anesthetic protocols are effective for pediatric ESWL but have distinct side effect profiles.
  • Neither protocol demonstrated significant differences in ease of application or analgesic efficacy.
  • Safe administration requires experienced anesthesiologists in a monitored, well-equipped setting.
Abstract

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