• Carsten Sorensen, Paramjit Chandhoke, Michael Moore, Connie Wolf, and Ali Sarram.
• Department of Surgery (Urology), University of Colorado Health Sciences Center and Kidney Stone Center of the Rocky Mountains, Denver, Colorado, USA.
• J. Urol. 2002 Jul 1; 168 (1): 35-7.

PurposeWe compared the impact of intravenous sedation versus general anesthesia on the efficacy of extracorporeal shock wave lithotripsy.Materials And MethodsFrom November 1997 to May 1998, 295 patients with a single renal or upper ureteral radioopaque stone of less than 2 cm. were treated with the Doli 50 lithotriptor (Dornier Medical Systems, Marietta, Georgia). The treating anesthesiologist and patient together elected intravenous sedation or general anesthesia. Of the 92 patients 60 (65%) treated under intravenous sedation and 126 of the 203 (62%) treated under general anesthesia had 3-month followup records available for review. Extracorporeal shockwave lithotripsy was considered a failure if residual stone fragments remained after 3 months, or an auxiliary procedure or re-treatment was required.ResultsAt 3 months the stone-free rate in patients treated under intravenous sedation was 55% compared with 87% in those treated under general anesthesia (p <0.001). There was no statistically significant difference in treatment time or the power index in the 2 groups. Stone size (1 to 10 versus 11 to 20 mm.) did not significantly affect the anesthesia specific stone-free rate.ConclusionsFor single renal or upper ureteral stones less than 2 cm. a significantly better 3-month stone-free rate is achieved with the Doli 50 lithotriptor when general anesthesia is used instead of intravenous sedation.

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