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[Extracorporeal shockwave lithotripsy--what type of anesthesia?]
Schweizerische Medizinische Wochenschrift
|March 21, 1987
Summary
Shock wave lithotripsy for kidney stones requires anesthesia. Epidural anesthesia with carbonated lidocaine is highly effective for over 90% of patients, enabling early mobilization.
Area of Science:
- Urology
- Anesthesiology
Background:
- Shock wave lithotripsy (SWL) for renal calculi is painful, necessitating anesthesia.
- Anesthesia options include general or regional techniques.
Purpose of the Study:
- To evaluate the suitability of different anesthesia methods for SWL.
- To determine the preferred anesthetic for over 1000 SWL treatments.
Main Methods:
- Analysis of over 1000 SWL treatments at the University Hospital of Zurich.
- Comparison of epidural anesthesia with carbonated lidocaine versus general anesthesia.
- Assessment of anesthetic onset, duration, and patient mobilization.
Main Results:
- Over 90% of SWL treatments were performed under epidural anesthesia.
- Epidural anesthesia required extension to Th 4/5 for complete pain blockade.
- 1-2% carbonated lidocaine provided rapid onset and adequate duration for early patient mobilization.
- Approximately 3% of patients received general anesthesia due to specific reasons.
- General anesthesia involved intubation and ventilation with minimal displacement of calculi.
Conclusions:
- Epidural anesthesia with carbonated lidocaine is a highly suitable method for the majority of SWL procedures.
- This technique facilitates early patient mobilization post-treatment.
- General anesthesia remains an option for specific patient cases.