Extracorporeal Shock Wave Lithotripsy Using Only Intravenous Analgesia with an Unmodified Dornier HM3 Lithotripter

Abstract

The original Dornier HM3 lithotripter required general or regional anesthesia for virtually all patients. Treatment at lower pressures can be accomplished with this machine by reducing the kilovoltage (kV) to 12 kV to 16 kV, allowing treatment using intravenous sedation alone. Many patients with single or multiple stones of low to medium volume can be successfully treated with this new technique. General or regional anesthesia is reserved for patients requiring auxiliary procedures (i.e., retrograde stone manipulation, placement of ureteral stents), for patients with large stone volume or dense stones, for patients with a known high incidence of retreatment, or by patient preference. One hundred fifteen patients treated with this new approach are compared to previous experience with the HM3 utilizing 18 kV to 24 kV and general or regional anesthesia.