Evaluation of extracorporeal shock wave lithotripsy without anesthesia using a Dornier HM3 lithotriptor without...

Area of Science:

• Urology
• Nephrology
• Medical Devices

Background:

• Urolithiasis management often involves extracorporeal shock wave lithotripsy (ESWL).
• Traditional ESWL typically requires regional or general anesthesia.
• Patient comfort and safety during ESWL are significant considerations.

Purpose of the Study:

• To evaluate the efficacy and patient tolerance of anesthesia-free ESWL.
• To compare outcomes of anesthesia-free ESWL with conventional anesthesia-based ESWL.
• To assess the feasibility of using a technically unmodified Dornier HM3 lithotriptor for anesthesia-free ESWL.

Main Methods:

• ESWL was performed on 210 urolithiasis patients without anesthesia, using a Dornier HM3 lithotriptor.
• Patients received premedication (pethidine, diazepam) and topical anesthetic cream.
• Low energy settings (14-16 kV) were employed, with results compared to 250 patients treated with anesthesia (18-23 kV).

Main Results:

• Over 90% of patients reported moderate and acceptable pain levels.
• Less than 3% found the anesthesia-free treatment unpleasant.
• Stone-free rates at 4 weeks were similar to the anesthesia group, despite a slightly higher number of sessions for larger stones.

Conclusions:

• Anesthesia-free ESWL using a Dornier HM3 lithotriptor is a successful and well-tolerated alternative for most urolithiasis patients.
• This approach offers a viable option, potentially reducing the need for anesthesia-related complications.
• Further adoption of anesthesia-free ESWL may be considered as an alternative to equipment modifications.