title: Anesthetic requirements during electromagnetic extracorporeal shock wave lithotripsy.
abstract: An important aspect of modern extracorporeal shock wave lithotripsy is the ability to perform the procedure without anesthesia. Between June 1987 and April 1990, a total of 7,500 treatments were performed in our Lithotripsy Unit, using the Lithostar (Siemens AG, Erlangen, FRG): moreover 80% of the treatments were carried out as an anesthesia-free outpatient service. All treatments were reviewed for anesthetic requirements. Epidural anesthesia was performed in 74/7,500 (0.98%) treatments: during the initial period, the first 70 procedures were systematically performed under epidural anesthesia, and in 4 later cases of simultaneous endoscopic stone manipulation. Local skin infiltration was applied at the coupling site in 658/7,500 (8.7%) treatments. With increasing experience and technological improvement, 6,229/7,500 (83%) procedures were performed later on with only mild sedation: 1 mg of lorazepam orally 30 min before the treatment. Intravenous sedation was required in 510/7,500 (6.8%) cases because of painful local irritation, especially when treating calculi close to sites where shock waves can progress along the ribs. General anesthesia was required in all 28 children (0.4%).
authors.affiliation: Department of Urology, University Hospital Sint-Pieter, Catholic University of Leuven, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Vandeursen
authors.forename: G
authors.initials: G
authors.lastname: Pittomvils
authors.forename: E
authors.initials: E
authors.lastname: Matura
authors.forename: R
authors.initials: R
authors.lastname: Boving
authors.forename: L
authors.initials: L
authors.lastname: Baert
mesh_terms: D000328:Adult; D000758:Anesthesia; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000772:Anesthesia, Local; D002648:Child; D016292:Procedural Sedation; D003975:Diazepam; D006801:Humans; D008012:Lidocaine; D008096:Lithotripsy; D008140:Lorazepam
chemical_list: D008012:Lidocaine; D008140:Lorazepam; D003975:Diazepam