The Effects of Propofol as s Sole Intravenous Anesthetics on Endourologic Transurethral Lithotripsy / 대한마취과학회지

BACKGROUND: Propofol is an intravenous anesthetic characterized by rapid induction and prompt recovery. Recently, its is used widely in clinical practice, especially when early discharge is advisable. We conducted this study for the evaluation of the effects of propofol as a sole intravenous anesthetic on the operation with minimal pain such as TUL(transurethral lithotripsy). METHODS: Patients were recruited for ASA class 1 and 2 from those who received TUL operation. Propofol was administered 2 mg/kg for induction and continuously infused at the rate of 1.2~1.4 mg/kg/hr after the loss of consciousness. With the stabilization of the vital signs, we reduced the dose of propofol to 1.0~1.2 mg/kg/hr. We checked the patients' movement, vital signs, recovery time and monitored the appearance of the symtoms such as nausea, vomiting postoperatively. RESULTS: 1) The average time of operation was 15+/-12 minutes. 2) The average recovery time was 15+/-9 minutes(range 2~30 min). 3) Blood pressure and peripheral oxygen saturation(SpO2) were declined during anesthesia, but SpO2 was normalized in the recovery room. 4) No significant complications were observed. 5) Mild movement of the patient was noticed in the begining of operation, but it did not affect the surgical procedure. CONCLUSIONS: Propofol was effective as a sole intravenous anesthetic to minimize postoperative complications such as nauea, vomiting for TUL with minimal pain.

Experience of Extracorporeal Shock Wave Lithotripsy with Northgate SD-3 in 2500 Patients of Urinary Calculi / 대한비뇨기과학회지

Extracorporeal shock wave lithotripsy (ESWL) has been established as the first line procedure of urinary stone treatment. To evaluate clinical efficacy and to identify the criteria of proper patient selection tempered by understanding of the limitations of the ESWL therapy available. We reviewed 2500 patients with urinary stone treated by ESWL using the Northgate SD-3 lithotriptor between June, 1989 and May, 1995. The results were obtained as follows: 1. The total average success rate of treatment was 92.6%. 2. The success rate according to stone locations were 88% in kidney (1074/1214 cases), 93.5% in ureter(1275/1323 cases) and 92.7% in bladder (38/41 cases). 3. The success rate according to stone size measured on the KUB film were 98.0% below 10mm, 91.0% in 11 - 20mm, 80.0% in 21 - 30mm and 68.7% over 31mm. 4. The average numbers of treatment were 2.3 sessions and the mean number of shock per treatment were 1940 +- 230. 5. Of the 2578 cases, 2178(84.5%) were treated by ESWL monotherapy. For auxiliary procedure, Double-J stents were placed in 64 cases and nephrostomy in 49 cases. Stone manipulation including push back, Dormia basket, Ureteroscopy were performed in 161 cases. We conclude that as a highly effective and minimally invasive treatment modality, ESWL has become to be the therapy of choice in 85.5% of urinary stones. When ESWL therapy is less effective for stone size larger than 3 cm(68.7%), staghorn calculi (65.5%) and presence of anatomical barriers, the additional endourologic procedures need to be indicated.

Experience of Extracorporeal Shock Wave Lithotripsy with Northgate SD-3 in 2500 Patients of Urinary Calculi / 대한비뇨기과학회지

Extracorporeal shock wave lithotripsy (ESWL) has been established as the first line procedure of urinary stone treatment. To evaluate clinical efficacy and to identify the criteria of proper patient selection tempered by understanding of the limitations of the ESWL therapy available. We reviewed 2500 patients with urinary stone treated by ESWL using the Northgate SD-3 lithotriptor between June, 1989 and May, 1995. The results were obtained as follows: 1. The total average success rate of treatment was 92.6%. 2. The success rate according to stone locations were 88% in kidney (1074/1214 cases), 93.5% in ureter(1275/1323 cases) and 92.7% in bladder (38/41 cases). 3. The success rate according to stone size measured on the KUB film were 98.0% below 10mm, 91.0% in 11 - 20mm, 80.0% in 21 - 30mm and 68.7% over 31mm. 4. The average numbers of treatment were 2.3 sessions and the mean number of shock per treatment were 1940 +- 230. 5. Of the 2578 cases, 2178(84.5%) were treated by ESWL monotherapy. For auxiliary procedure, Double-J stents were placed in 64 cases and nephrostomy in 49 cases. Stone manipulation including push back, Dormia basket, Ureteroscopy were performed in 161 cases. We conclude that as a highly effective and minimally invasive treatment modality, ESWL has become to be the therapy of choice in 85.5% of urinary stones. When ESWL therapy is less effective for stone size larger than 3 cm(68.7%), staghorn calculi (65.5%) and presence of anatomical barriers, the additional endourologic procedures need to be indicated.