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Transcutaneous Electrical Nerve Stimulator: An Approach to Anesthesia-Free Shock Wave Lithotripsy with the Lithostar Unit

  • Juan Fernandez
  • Ralph V. Clayman
  • Dianna Gray
  • Bruce L. McClennan

Abstract

Extracorporeal shock wave lithotripsy (ESWL) has now evolved to the point where most treatments are rendered either without the need for anesthesia or with the use of only minimal, intravenous sedation. The Siemens Lithostar machine was originally designed to be used with intravenous sedation in combination with local anesthesia. Herein, we report use of a transcutaneous electrical nerve stimulator unit to achieve satisfactory analgesia in patients undergoing shock wave lithotripsy. Overall, 60% of patients were able to undergo treatment with only a TENS unit. More importantly, when the total number of shock waves was limited to 3,000 or fewer, 90% of patients were able to undergo therapy without any supplemental intravenous or local anesthesia. The TENS unit is inexpensive to use, noninvasive, has no associated morbidity, and allows for the same degree of stone fragmentation as is seen with more invasive forms of anesthesia.

Keywords

Shock Wave Intravenous Sedation Pulse Oximeter Shock Wave Lithotripsy Extracorporeal Shock Wave Lithotripsy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Juan Fernandez
    • 1
  • Ralph V. Clayman
    • 1
    • 2
  • Dianna Gray
    • 3
  • Bruce L. McClennan
    • 2
  1. 1.Division of Urologic SurgeryWashington University School of Medicine and Midwest Stone instituteSt. LouisUSA
  2. 2.Department of RadiologyWashington University School of Medicine and Midwest Stone instituteSt. LouisUSA
  3. 3.Department of Physical Medicine and RehabilitationWashington University School of Medicine and Midwest Stone instituteSt. LouisUSA

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