Darancette G, Bourdalle-Badie C, Robert S
Département d'Anesthésie-Réanimation, Groupe Hospitalier Pellegrin-Tripode, Bordeaux.
Ann Fr Anesth Reanim. 1989;8(4):347-54. doi: 10.1016/s0750-7658(89)80076-0.
Extracorporeal shock wave lithotripsy has become the main technique for treating renal lithiasis. It has many repercussions on anaesthesia. The fundamental technical concepts of lithotriptors are reviewed. The problems due to the different systems (electrohydraulic or piezoelectric--the most widespread in France) are discussed. Electrohydraulic systems, which are more adapted to the treatment of large stones (diameter greater than 2 cm), require the immersion of the patient. As a result, there are analgesic, cardiovascular, respiratory and temperature repercussions on the anaesthetic management of these patients. General anaesthesia is generally more appropriate for this technique. On the other hand, piezoelectric systems are more adapted to the treatment of medium-sized or small calculi (diameter less than 2 cm), and do not require immersion. Anaesthesia is often not required for the use of this technique, but, if necessary, local, regional or general anaesthesia may be used. For either technique, the anaesthetic protocol must be adapted to the patient's and the surgical indications.
体外冲击波碎石术已成为治疗肾结石的主要技术。它对麻醉有诸多影响。本文回顾了碎石机的基本技术概念。讨论了不同系统（液电式或压电式——在法国最广泛使用）所带来的问题。液电式系统更适合治疗较大结石（直径大于2厘米），需要患者浸入水中。因此，对这些患者的麻醉管理会产生镇痛、心血管、呼吸和体温方面的影响。全身麻醉通常更适合这种技术。另一方面，压电式系统更适合治疗中小型结石（直径小于2厘米），且不需要浸入水中。使用这种技术时通常不需要麻醉，但如有必要，可采用局部、区域或全身麻醉。对于这两种技术，麻醉方案都必须根据患者情况和手术指征进行调整。
