Anesthesia for ESWL
Most of the lithotripsy done requires physician administered general anesthesia. Prior to ESWL the patient will be contacted by the anesthesiologist. At that time the doctor will ask the patient questions about the patient's medical problems, current medication, and the details about any previous anesthetics. It is important that the patient make a list of the current medication, the dose, and how often it is taken.
Some centers use sedation for lithotripsy. While this sounds desirable, the kidney stones do not fragment well. When the patient is awake, the kidney (and stone) move up and down 2-4 inches with each breath. When this occurs, the stone moves out of the shock wave focus sphere resulting in less fragmentation. For this reason, we strongly recommend a general anesthetic with controlled breathing when it can be done safely. This gives better fragmentation and lessens the possibility of multiple treatments. A single treatment usually takes one hour of less of general anesthesia.