Anesthetic management for extracorporeal shock wave lithotripsy

This report reviews the anesthetic experiences of 411 patients underwent extracorporeal shock wave lithotripsy at the Tranomon Hospital extending from March 1985 to February 1986. The continuous epidural anesthesia was successfully applied to 409 of 411 cases. The general anesthesia was applied to the other 2 cases in those the epidural anesthesia was contraindicated. Instantanious changes of ST-wave or conduction disturbances on electrocardiogram were observed during the procedure in 12 of 411 cases. However, this adverse findings were disappeared with interruption of the procedure. At the present, the mechanism of these phenomena was unclear. The authors have indicated in this article that continuous epidural anesthesia was most suitable for the management of extracorporeal shock wave lithotripsy, and that further careful clinical observation and evaluations for cardiac emergency must be carried out in this therapy.