Urolithiasis Clinical Trial
Official title:
Comparison of General Anaesthesia and Sedation on the Stone Fragmentation Efficacy of the Third Generation Lithotriptor
The aim of the study is to compare the impact intravenous sedation versus general anesthesia on the efficacy of stone fragmentation in extracorporeal shock wave lithotripsy treatment.
The newer lithotriptors were reported to be less efficacious than the Dornier HM3
lithotriptor; and it is not clear the reason why there is decrease in efficacy of the new
lithotriptors. Is it due to their small focal point or to increased patient movement while
under intravenous sedation.When the patients get sedated then it will be difficult to
control their respiratory movements. Retrospective comparisons suggest that intravenous may
facilitate earlier discharge if no manipulation of the airway was done; but they are often
associated with pain, hypoxemic respiratory episodes and disruptive movements during
lithotripsy Instead of intravenous sedation, general anesthesia offer pain free procedures,
no movement of the patient and controlled movement of the respiration leads to stable
position of the urinary stones and receives persistent shock wave energy on to the stone
bringing about better and early fragmentation. Hence we work on the hypothesis that the new
generation shock wave lithotripters have a small focal point, every movement of the stone
during the respiration or patient movement, will take the stone out of the focus and there
results in loss of shocks leading to lithotripsy failure and use of more fluoroscopy for
refocusing the stone.
Thus we think the proper choice of anesthetic technique will improve the efficacy of stone
fragmentation in shock wave lithotripsy treatment at least in those who are obese and
suffers from occult sleep- apnoea syndrome
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
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