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Online Published: 24 Jul 2021
 


Semirigid ureteroscopic lithotripsy under local anaesthesia and intravenous analgesia: Analysis of effectiveness, safety and patient's tolerability

Girish Kumar Sharma, Pamposh Raina, Manjeet Kumar, Kailash Barwal, Vineet Kumar, Sanjeev Chauhan.


Abstract
Introduction: Improvement in technology for endoscopic instrumentation and lithotripsy devices has allowed much advancement in ureteroscopic lithotripsy and has, to an extent, replaced open stone surgery. Ureteroscopic lithotripsy (URSL) is a more effective treatment of ureteric stones as compared to extracorporeal shock wave lithotripsy (ESWL) but has a downside as it requires spinal or general anaesthesia.
Patients and methods: In this record-based cohort study, we evaluated the outcome of URSL under local anaesthesia and intravenous analgesia in 150 patients with lower and mid ureteric calculus to establish its feasibility, safety, and tolerability.
Results: Association of various factors with overall outcome in terms of stone-free status and pain was analyzed in 149 patients. In patients with a stone of size < 10mm, calculus was completely fragmented and retrieved in 94.7%, while in patients with calculus of size >10mm, stone-free status was achieved in 82.2% ( statistically significant P value 0.016 ). The success rate of URSL for mid ureteric calculus was 86% whereas, for lower and VUJ calculus, it was 90.2%.
DJ stent placement before planned URSL was done in 81.3% of patients. We observed no statistically significant difference in achieving stone-free status with respect to laterality, location of calculus (P-value 0.427), and DJ stenting before URSL (P-value 0.430).
Laterality of calculus (left-sided) had a statistically significant effect on the severity of pain in our study(P-value 0.047). URSL under local anaesthesia and intravenous analgesia were acceptable to 70.5 % of patients, while 6% of patients opined it as a painful procedure. We have observed a statistically significant relationship of calculus size with achieving stone-free status (P-value 0.016).
Conclusions: Our findings suggest that URSL as a daycare procedure is feasible under local anaesthesia and intravenous analgesia, as a majority of patients tolerate the procedure and outcome in form of stone clearance is not compromised.

Key words: Ureteroscopic lithotripsy (URSL), DJ Stenting, Stone free status (SFS)


 
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How to Cite this Article
Pubmed Style

Sharma GK, Raina P, Kumar M, Barwal K, Kumar V, Chauhan S. Semirigid ureteroscopic lithotripsy under local anaesthesia and intravenous analgesia: Analysis of effectiveness, safety and patient's tolerability. Int J Surg Med. 2021; 7(4): 14-18. doi:10.5455/ijsm.Semirigid-ureteroscopic-lithotripsy

Web Style

Sharma GK, Raina P, Kumar M, Barwal K, Kumar V, Chauhan S. Semirigid ureteroscopic lithotripsy under local anaesthesia and intravenous analgesia: Analysis of effectiveness, safety and patient's tolerability. https://www.ejos.org/?mno=77129 [Access: September 12, 2024]. doi:10.5455/ijsm.Semirigid-ureteroscopic-lithotripsy

AMA (American Medical Association) Style

Sharma GK, Raina P, Kumar M, Barwal K, Kumar V, Chauhan S. Semirigid ureteroscopic lithotripsy under local anaesthesia and intravenous analgesia: Analysis of effectiveness, safety and patient's tolerability. Int J Surg Med. 2021; 7(4): 14-18. doi:10.5455/ijsm.Semirigid-ureteroscopic-lithotripsy


Vancouver/ICMJE Style

Sharma GK, Raina P, Kumar M, Barwal K, Kumar V, Chauhan S. Semirigid ureteroscopic lithotripsy under local anaesthesia and intravenous analgesia: Analysis of effectiveness, safety and patient's tolerability. Int J Surg Med. (2021), [cited September 12, 2024]; 7(4): 14-18. doi:10.5455/ijsm.Semirigid-ureteroscopic-lithotripsy


Harvard Style

Sharma, G. K., Raina, . P., Kumar, . M., Barwal, . K., Kumar, . V. & Chauhan, . S. (2021) Semirigid ureteroscopic lithotripsy under local anaesthesia and intravenous analgesia: Analysis of effectiveness, safety and patient's tolerability. Int J Surg Med, 7 (4), 14-18. doi:10.5455/ijsm.Semirigid-ureteroscopic-lithotripsy


Turabian Style

Sharma, Girish Kumar, Pamposh Raina, Manjeet Kumar, Kailash Barwal, Vineet Kumar, and Sanjeev Chauhan. 2021. Semirigid ureteroscopic lithotripsy under local anaesthesia and intravenous analgesia: Analysis of effectiveness, safety and patient's tolerability. International Journal of Surgery and Medicine, 7 (4), 14-18. doi:10.5455/ijsm.Semirigid-ureteroscopic-lithotripsy


Chicago Style

Sharma, Girish Kumar, Pamposh Raina, Manjeet Kumar, Kailash Barwal, Vineet Kumar, and Sanjeev Chauhan. "Semirigid ureteroscopic lithotripsy under local anaesthesia and intravenous analgesia: Analysis of effectiveness, safety and patient's tolerability." International Journal of Surgery and Medicine 7 (2021), 14-18. doi:10.5455/ijsm.Semirigid-ureteroscopic-lithotripsy


MLA (The Modern Language Association) Style

Sharma, Girish Kumar, Pamposh Raina, Manjeet Kumar, Kailash Barwal, Vineet Kumar, and Sanjeev Chauhan. "Semirigid ureteroscopic lithotripsy under local anaesthesia and intravenous analgesia: Analysis of effectiveness, safety and patient's tolerability." International Journal of Surgery and Medicine 7.4 (2021), 14-18. Print. doi:10.5455/ijsm.Semirigid-ureteroscopic-lithotripsy


APA (American Psychological Association) Style

Sharma, G. K., Raina, . P., Kumar, . M., Barwal, . K., Kumar, . V. & Chauhan, . S. (2021) Semirigid ureteroscopic lithotripsy under local anaesthesia and intravenous analgesia: Analysis of effectiveness, safety and patient's tolerability. International Journal of Surgery and Medicine, 7 (4), 14-18. doi:10.5455/ijsm.Semirigid-ureteroscopic-lithotripsy


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