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Is ESWL more effective when conducted

compared with

conscious

sedation?

James Ha es

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• ’

• ys c ney seases

• Metabolic disorders

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• Most stones can pass through the urinary

• Medical treatment

• Surgical treatment

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Extracorporeal Shockwave Lithotripsy

• treatment of kidney stones

•

Shock waves are created outside the body trave t roug o y t ssues unt t ey t t e denser stones

• The stones break down into sand ‐like articles

and are

easily

passed

in

the

urine

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• Lithotripters use either x‐rays or ultrasound to

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• ‐

• Minimum mor i ity

• Associated with pain and discomfort

• Anaesthesia is needed

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•

• Newer it otripters associate wit ess pain –

sedation is more common

• Benefits to both

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•

• Recent post partum

• Currently breastfeeding

• Difficulties during pregnancy with this calculus

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• showed no pelvicalceal dilation

•

ESWL was commenced under conscious se at on

• She did not tolerate the procedure well

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• breastfeeding

•

It is safe to nurse once awake and alert

• B that time the amount of medication in the bloodstream is low enough that the amounts in the milk would not be si nificant

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'

T e point at w ic you wa e up a ter genera

anaesthesia is the point where enough of the rug as e t your system t at t no onger as an effect”

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•

treatment done under general anaesthesia

sedation

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•

ESWL treatment between 19 June 1995 and 3

• T e ata was co ecte prospect ve y ut analysed retrospectively

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• ,

horn stones or previous interventions in the

excluded

• Stone removal was considered successful if

t e stone was ro en nto ragments sma er than 4mm

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•

patients would have been treated successfully

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• ,

non stag horn stones without urinary tract

increased success rate for ESWL treatment

• This result is statistically significant, however

urt er researc w e requ re to eterm ne whether it is also clinically significant.

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•

patient factors into account when making this

• T e ene ts t at se at on o ers over genera anaesthesia are small and there is a relatively

sma ncrease rate o success w t genera anaesthesia

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Thank you!