Recovery room risk and outcome associated with renal extracorporeal shock wave lithotripsy.

STUDY OBJECTIVES

To determine (1) the general risk and outcome in the recovery room among 4 different anesthetic techniques associated with 2 different extracorporeal shock wave lithotripsy (ESWL) machines and (2) any gender-related differences among patients undergoing ESWL.

DESIGN

Retrospective statistical analysis.

SETTING

University medical center.

PATIENTS

2,203 ASA physical status I-IV patients undergoing ESWL over a 46-month period.

INTERVENTIONS

A review of the chart records of patients who received 1 of 4 anesthetic techniques (general, spinal, epidural, or monitored anesthesia care) on 1 of 2 ESWL machines.

MEASUREMENTS AND MAIN RESULTS

A positive finding was defined as a complication and/or side effect of such significance as to require a treatment order or recovery room note on the patient's chart. The main complications and/or side effects were nausea and/or vomiting, flank pain, and hypertension. Female patients experienced flank pain and nausea and/or vomiting with general anesthesia and monitored anesthesia care at approximately twice the frequency of males.

CONCLUSIONS

(1) Overall, ESWL is relatively safe. Both machine types and all anesthetic techniques exhibited a low risk and good outcome. (2) There appear to be gender-related differences during ESWL. Female and male patients may have different pain and nausea and/or vomiting thresholds during ESWL.