Comparison of intravenous sedation versus general anesthesia on the efficacy of the Doli 50 lithotriptor.
OBJECTIVE
We compared the impact of intravenous sedation versus general anesthesia on the efficacy of extracorporeal shock wave lithotripsy.


METHODS
From November 1997 to May 1998, 295 patients with a single renal or upper ureteral radioopaque stone of less than 2 cm. were treated with the Doli 50 lithotriptor (Dornier Medical Systems, Marietta, Georgia). The treating anesthesiologist and patient together elected intravenous sedation or general anesthesia. Of the 92 patients 60 (65%) treated under intravenous sedation and 126 of the 203 (62%) treated under general anesthesia had 3-month followup records available for review. Extracorporeal shockwave lithotripsy was considered a failure if residual stone fragments remained after 3 months, or an auxiliary procedure or re-treatment was required.


RESULTS
At 3 months the stone-free rate in patients treated under intravenous sedation was 55% compared with 87% in those treated under general anesthesia (p <0.001). There was no statistically significant difference in treatment time or the power index in the 2 groups. Stone size (1 to 10 versus 11 to 20 mm.) did not significantly affect the anesthesia specific stone-free rate.


CONCLUSIONS
For single renal or upper ureteral stones less than 2 cm. a significantly better 3-month stone-free rate is achieved with the Doli 50 lithotriptor when general anesthesia is used instead of intravenous sedation.
Sorensen
Carsten
C
Department of Surgery (Urology), University of Colorado Health Sciences Center and Kidney Stone Center of the Rocky Mountains, Denver, Colorado, USA.
Chandhoke
Paramjit
P
Moore
Michael
M
Wolf
Connie
C
Sarram
Ali
A
D000768:Anesthesia, General; D016292:Procedural Sedation; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000295:instrumentation*; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*