Influence of Dornier HM3 System on Respiration During Extracorporeal Shock-Wave Lithotripsy

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Abstract
Atients anesthetized with epidural blockade. On immersion, surface abdominal pressure and respiratory frequency (f) increased. Tidal volume (VT) and arterial saturation (Sa02) decreased. After intravenous midazolam 0.045 mglkg body weight, VT decreased further to 35% below pre-immersion values and stone excursions measured by fluoroscopy diminished by more than 50%; reduction of VT and stone excursions were linearly correlated (R=0.45). Sa02 declined sharply to 6.1% (range −1.5–13.8%) below pre-immersion values, whereas end-tidal C02 (PETC02) increased more slowly andf remained above the pre-immersion rate. In three patients, Sa02 decreased to below 85% but was rapidly restored to 98–100% by oxygen administration. The respiratory effects of sedative drugs are exaggerated by the Dornier HM3 system, and continuous monitoring of gas exchange and appropriate oxygen administration are recommended in patients receiving regional anesthesia and sedation. Address correspondence to Dr. Bromage, Department of Anesthesiology, Christiana Hospital, 4755 Ogletown-Stanton Road, Newark, DE 19718. We thank Dr. Mohamed Naguib, FFARCSI for statistical assistance. Accepted for publication October 4, 1988. © 1989 International Anesthesia Research Society...

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