title: Sticks and stones: use of acupuncture in extracorporeal shockwave lithotripsy.
abstract: OBJECTIVE
  Extracorporeal shockwave lithotripsy (SWL) is an effective noninvasive, outpatient method of stone clearance. In our unit, it is performed using a combination of oral analgesia and intravenous sedation, which allows us to treat to therapeutic levels in the vast majority of our patients. However, we have encountered patients who do not tolerate various elements of the analgesia protocol and thus cannot be treated to full effect. The options for these people are currently limited to either SWL under formal sedation or epidural or general anesthetic or the use of another technique of stone clearance, such as percutaneous nephrolithotomy, which may not be as appropriate, and again necessitates an anesthetic, an inpatient stay, or both.
  
  
  METHODS
  We describe three patients who had previously failed SWL who received acupuncture in place of standard analgesia prior to the next treatment.
  
  
  RESULTS
  All three patients were able to tolerate the procedure better and were treated at a higher level with more shocks than in the previous session. No side effects were noted.
  
  
  CONCLUSIONS
  We propose that acupuncture may be considered in patients unable to take standard sedoanalgesia. It is a cost-effective, safe method of inducing sedation with analgesia and had no demonstrable side effects in our series. It provides an attractive alternative to the use of general or regional anesthetics in these patients.
authors.affiliation: Department of Urology, St. George's Hospital, Blackshaw Road, London SW17 0RE, UK. nquatan@hotmail.com
authors.forename: Nadine
authors.initials: N
authors.lastname: Quatan
authors.forename: Christine
authors.initials: C
authors.lastname: Bailey
authors.forename: Anna
authors.initials: A
authors.lastname: Larking
authors.forename: P John
authors.initials: PJ
authors.lastname: Boyd
authors.forename: Nicholas
authors.initials: N
authors.lastname: Watkin
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000284:Administration, Oral; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016292:Procedural Sedation; D006801:Humans; D007262:Infusions, Intravenous; D008096:Lithotripsy / Q000379:methods*; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D017060:Patient Satisfaction; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000175:diagnosis / Q000628:therapy*
chemical_list: D000700:Analgesics