Connelly N R, Weinstock A D
Department of Anesthesiology, Yale University School of Medicine, Yale-New Haven Hospital, CT 06510.
Anesth Analg. 1990 Mar;70(3):299-302. doi: 10.1213/00000539-199003000-00012.
Extracorporeal shock wave lithotripsy has recently been introduced in clinical trials for the treatment of cholelithiasis. General anesthesia, epidural anesthesia, and intravenous opiates have been used in the anesthetic management of patients undergoing this procedure. This report details our anesthetic management, which was used in 23 patients who underwent 27 procedures, and presents three illustrative cases. A continuous infusion of alfentanil and a 0.625-2.5-mg dose of droperidol were administered to the patients who were easily arousable during the procedure, and were able to cooperate with positioning change requests. Our patients did not develop apnea, hemodynamically significant bradycardia, or chest wall rigidity. One patient became nauseated, and one patient experienced a hypotensive episode that was unheralded by a change in respiratory rate, heart rate, or oxygen saturation. The patients were comfortable throughout the procedure, alert upon arrival to the postanesthesia care unit, and satisfied with this technique. A continuous infusion of alfentanil can be successfully used for the management of patients undergoing biliary lithotripsy.
体外冲击波碎石术最近已被引入用于治疗胆石症的临床试验中。全身麻醉、硬膜外麻醉和静脉注射阿片类药物已被用于接受该手术患者的麻醉管理。本报告详细介绍了我们用于23例患者（共进行了27次手术）的麻醉管理方法，并呈现了三个说明性病例。对于在手术过程中容易唤醒且能够配合体位改变要求的患者，给予持续输注阿芬太尼和0.625 - 2.5毫克剂量的氟哌利多。我们的患者未出现呼吸暂停、血流动力学上显著的心动过缓或胸壁僵硬。一名患者出现恶心，一名患者经历了低血压发作，且呼吸频率、心率或血氧饱和度均未出现变化。患者在整个手术过程中感觉舒适，到达麻醉后护理单元时清醒，并对该技术感到满意。持续输注阿芬太尼可成功用于接受胆道碎石术患者的管理。
