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Related Experiment Videos

[Anesthesia during extracorporeal shock wave lithotripsy].

G Molter, K Hutschenreuter, U Büch

    Anaesthesiologie Und Reanimation
    |January 1, 1989
    PubMed
    Summary

    Epidural anesthesia and opioid analgesia are suitable for extracorporeal shock wave lithotripsy (ESWL). Epidural anesthesia impacts glomerular filtration rate (GFR), while opioid analgesia offers stable hemodynamics with mild side effects.

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    Interpleural analgesia does not influence postthoracotomy pain.

    Anesthesia and analgesia·2000

    Area of Science:

    • Anesthesiology
    • Nephrology
    • Urology

    Context:

    • Extracorporeal shock wave lithotripsy (ESWL) is a common procedure for kidney stones.
    • Appropriate anesthesia is crucial for patient comfort and procedural success during ESWL.
    • Evaluating different anesthetic techniques, including epidural anesthesia and opioid analgesia, is essential.

    Purpose:

    • To assess the efficacy and safety of epidural anesthesia and opioid analgesia for ESWL.
    • To investigate the impact of epidural anesthesia on glomerular filtration rate (GFR) during ESWL.
    • To evaluate cardiovascular and respiratory effects of opioid analgesia during ESWL.

    Summary:

    • Epidural anesthesia with bupivacaine demonstrated stable cardiovascular parameters in 161 patients, though it temporarily reduced GFR, which then increased with shock wave application.
    • Opioid analgesia using alfentanil in 360 patients showed minimal impact on hemodynamics and maintained normal PaCO2 with oxygen support, despite mild drowsiness and rare respiratory events.
    • Extracorporeal piezoelectric lithotripsy (EPL) offers a non-invasive, potentially more cost-effective alternative to ESWL.

    Impact:

    • Epidural anesthesia and opioid analgesia are viable anesthetic options for ESWL, with careful monitoring for potential side effects.
    • Understanding the transient effects of epidural anesthesia on GFR during ESWL is important for patient management.
    • The development of non-invasive techniques like EPL may change future kidney stone treatment paradigms.

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