[The anesthesiological support for children in extracorporeal lithotripsy on the Urat-P apparatus]

The Urat-P lithotriptor made in this country was employed for remote lithotripsy (RLT) in 94 children with urolithiasis. Altogether 132 sessions were conducted. In 120 cases the concrement disintegration progressed in a sparing regimen (impulse duration 0.3-0.4 ms, shock wave energy 5-8 J). In the rest 12 cases there were additional hard impulses (0.5-0.6 ms, the energy 10-12 J). Anesthesiological and transfusiological problems are considered. It is shown that choice of anesthesiological defense is based on the clinical form of the disease, the concrement size, the child's age. Intubation anesthesia with artificial pulmonary ventilation is indicated for young children (under 5). Intravenous balanced anesthesia under normal respiration accompanies RLT in large coral calculi treated in senior children (6-14 years of age). Single stones (up to 1.5 sm) in them are managed under local infiltration anesthesia. It is stated that a valid choice of anesthesia and transfusion therapy warrants favourable conditions for RLT sessions, adverse effects of the impulses on the renal parenchyma and adjacent tissues lessen facilitating the fragments elimination and reducing the number of complications in the postoperative period.