title: Comparison of intravenous sedation versus general anesthesia on the efficacy of the Doli 50 lithotriptor.
abstract: 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.
authors.affiliation: Department of Surgery (Urology), University of Colorado Health Sciences Center and Kidney Stone Center of the Rocky Mountains, Denver, Colorado, USA.
authors.forename: Carsten
authors.initials: C
authors.lastname: Sorensen
authors.forename: Paramjit
authors.initials: P
authors.lastname: Chandhoke
authors.forename: Michael
authors.initials: M
authors.lastname: Moore
authors.forename: Connie
authors.initials: C
authors.lastname: Wolf
authors.forename: Ali
authors.initials: A
authors.lastname: Sarram
mesh_terms: 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*