title: Cardiac Dysrhythmias in Children Undergoing Extracorporeal Shock Wave Lithotripsy Under General Anesthesia or Propofol Sedation: A Prospective, Observational Cohort Study.
abstract: OBJECTIVE
  To assess the frequency and severity of cardiac dysrhythmias and identify any intraoperative or postoperative complications in children undergoing extracorporeal shock wave lithotripsy (ESWL).
  
  
  METHODS
  All children coming to our institution for ESWL from June 2014 to January 2015 were prospectively enrolled in an observational cohort study. Intraoperative cardiac dysrhythmias and perioperative and postoperative complications were recorded.
  
  
  RESULTS
  In total, 21 children aged 1-18 years were enrolled receiving a total of 26 treatments. Intravenous sedation was used in 19 cases and general anesthesia with an inhalational agent in 7 cases. Cardiac dysrhythmias occurred in 58% of children. No hemodynamic instability was noted. No therapies were terminated because of dysrhythmias, and there were no postoperative cardiac dysrhythmias.
  
  
  CONCLUSIONS
  ESWL remains a safe therapy for children with urinary stone disease. Although we experienced more dysrhythmias than currently published literature, there were no long-term adverse outcomes and children were able to go home the same day.
authors.affiliation: Department of Anaesthesia, Great Ormond Street Hospital, London, United Kingdom. Electronic address: jonathanmathers@me.com.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mathers
authors.affiliation: Department of Urology, Great Ormond Street Hospital, London, United Kingdom.
authors.forename: Bernardita Troncoso
authors.initials: BT
authors.lastname: Solar
authors.affiliation: Department of Anaesthesia, Great Ormond Street Hospital, London, United Kingdom.
authors.forename: Louise
authors.initials: L
authors.lastname: Harding
authors.affiliation: Department of Urology, Great Ormond Street Hospital, London, United Kingdom.
authors.forename: Naima
authors.initials: N
authors.lastname: Smeulders
authors.affiliation: Department of Anaesthesia, Great Ormond Street Hospital, London, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Hume-Smith
mesh_terms: D000293:Adolescent; D000768:Anesthesia, General / Q000379:methods; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000628:therapy; D008096:Lithotripsy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D061214:Patient Safety; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods; D052878:Urolithiasis / Q000000981:diagnostic imaging / Q000628:therapy*
chemical_list: D015742:Propofol