The initial experience of 4.5/6.5 Fr ureteroscopic laser lithotripsy under topical intraurethral anesthesia supplemented by preoperative and intraoperative medications

• Published in: International urology and nephrology 2023-07, Vol.55 (7), p.1677-1684
• Main Authors: Qu, Yuan, Fu, Quansheng, Qin, Xiaoping, Zhuo, Yumin, Chen, Zheng, Qu, Lijun
• Format: Article
• Language: English
• Subjects: Analgesia; Anesthesia; Anesthesia, Local; Antibiotics; Atropine; Bladder; Bupivacaine; Complications; Female; Hospitals; Humans; Kidney stones; Lasers; Lidocaine; Lithotripsy; Lithotripsy - methods; Lithotripsy, Laser - adverse effects; Lithotripsy, Laser - methods; Local anesthesia; Medicine; Medicine & Public Health; Nephrology; Pain; Pain perception; Patients; Postoperative; Retrospective Studies; Surgery; Surgical outcomes; Treatment Outcome; Ureteral Calculi - surgery; Ureteroscopy - adverse effects; Ureteroscopy - methods; Urology; Urology - Original Paper; Vomiting
• ISSN: 1573-2584; 0301-1623; 1573-2584
• DOI: 10.1007/s11255-023-03629-7

Purpose To assess the safety and effectiveness of the 4.5/6.5 Fr ureteroscopic laser lithotripsy (URSL) under topical intraurethral anesthesia (TIUA) compared to spinal anesthesia (SA). Methods A retrospective study was conducted on 47 (TIUA: SA = 23:24) patients receiving 4.5/6.5 Fr URSL from July 2022 to September 2022. For the TIUA group, atropine, pethidine, and phloroglucinol were used apart from lidocaine. In the SA group, patients received lidocaine and bupivacaine. We compare the two groups including stone-free rate (SFR), procedure time, anesthesia time, overall operative time, hospital stay, anesthesia failure, intraoperative pain, need for additional analgesia, cost, and complications. Results The conversion rate in the TIUA group was 4.35% (1/23). SFR was 100% in both groups. Surgical waiting time and anesthesia time were longer in the SA group (P