Extracorporeal Shock Wave Lithotripsy and Percutaneous Nephrolithotomy

Comparison of Percutaneous Nephrolithotomy Under Spinal Versus General Anesthesia: A Randomized Clinical Trial

“…[1][2][3] Urologists have modified their techniques in recent years to improve safety and efficacy and decrease morbidity. PCNL in different positions (prone, supine, prone-flexed, and flank), tubeless PCNL, and PCNL with a different type of anesthesia (spinal, general, and combined spinal-epidural) are some modifications have been described in previous studies.…”

Totally Ultrasonography-Guided Percutaneous Nephrolithotomy in the Flank Position

“…1 There are also concerns regarding PCNL in the prone position, especially in obese patients and those with compromised cardiopulmonary status and stature deformity for whom the prone position is not suitable. 2 With the above background and the potential benefits of totally ultrasonography-guided PCNL in the flank position, we adopted this technique for PCNLs in our center. Our previous experience was in using a combination of fluoroscopy and ultrasonography.…”

Target-controlled infusion of remifentanil or fentanyl during extra-corporeal shock-wave lithotripsy

“…At EC 50 , the probability of having a respiratory rate Ͻ10 was 4% (95% CI: 0-57%) for remifentanil and 56% (95% CI: 13-92%) for fentanyl. Hypoxaemia, vomiting and sedation were more frequent in Group F during and after the procedure (P Ͻ 0.05).Conclusions: A similar EC 50 but more respiratory depression, sedation and PONV were found with fentanyl TCI than with remifentanil TCI.The decreased pain associated with newer generation lithotriptors, has allowed the use of conscious sedation techniques instead of general or regional anaesthesia regimes [1]. Reduced recovery times [2] and decreased stone movement by tidal breathing [3] have been described as potential advantages, but these regimes have also been associated with a high incidence of respiratory depression and postoperative nausea and vomiting (PONV) [1,[4][5][6].…”

“…The decreased pain associated with newer generation lithotriptors, has allowed the use of conscious sedation techniques instead of general or regional anaesthesia regimes [1]. Reduced recovery times [2] and decreased stone movement by tidal breathing [3] have been described as potential advantages, but these regimes have also been associated with a high incidence of respiratory depression and postoperative nausea and vomiting (PONV) [1,[4][5][6].…”