Use of patient-controlled analgesia with alfentanil for extracorporeal shock wave lithotripsy.

Study Objective: To compare the efficacy of patient-controlled analgesia (PCA) to physician-controlled analgesia in patients undergoing extracorporeal shock wave lithotripsy (ESWL).

Design: Prospective, randomized trial.

Setting: New Jersey Kidney Stone Treatment Center at Robert Wood Johnson University Hospital, New Brunswick, NJ.

Use of a continuous alfentanil infusion for extracorporeal shock wave lithotripsy in the treatment of renal calculi.

Extracorporeal shock wave lithotripsy (ESWL) is the most widely used treatment for renal calculi. Newer second generation lithotripters are being produced, which are considered to be less painful than their prototypes. Thus, the trend in anesthesia for ESWL is away from general endotracheal and regional anesthesia and toward less involved and more easily monitored techniques such as intravenous analgesia (IVA).

Evidence for the role of spinal cord systems in Parkinson's disease-associated pain.

A patient with Parkinson's disease had severe levodopa-associated leg pain in a beginning-of-dose and peak-dose pattern. Local anesthetic block of the lumbar sympathetic chain or differential epidural block did not alter the pain. Spinal anesthesia abolished the pain.