Ureteroscopy under local anesthesia

Rittenberg, Michael H.; Ellis, David; Bagley, Demetrius H.

doi:10.1016/0090-4295(87)90385-2

Cited by 38 publications

(24 citation statements)

References 11 publications

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“…Safety, efficacy and cost effectiveness make sedoanalgesia a preferable alternative to general anaesthesia for many urological procedures including URSL. Rittenberg et al [9] were the first to report ureteroscopy under local anaesthesia. With the application of sedoanalgesia for various urological procedures in 1020 cases by Birch et al [2], patients treated as day care basis increased from 25% to 60%.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Ureteroscopic Lithotripsy for Ureteral Calculi Under Sedoanalgesia – A Prospective Study

et al. 2005

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Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Ureteroscopic Lithotripsy for Ureteral Calculi Under Sedoanalgesia – A Prospective Study

et al. 2005

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“…Rittenberg et al [7] demonstrated a 100% success rate among 30 ureteroscopies (rigid and flexible) with excellent durability with no need to interrupt the proce dure due to patient discomfort. Successful 7F flexible ure teroscopy for calculus removal with no anesthesia in a pregnant woman [8] was reported.…”

Section: Discussionmentioning

confidence: 99%

“…Few reports of urete roscopy under local anesthesia and sedation are available [7][8][9], We report our initial series of 28 ureteroscopies car ried out under sedation only and compare them to 18 referential ureteroscopies under general or regional anes thesia, in an operating room, in order to assess the appli cability of ureteroscopy as an outpatient ambulatory pro cedure.…”

Section: Introductionmentioning

confidence: 99%

Ureteroscopy for Ureterolithiasis with Sedation Only

Zisman

Siegel²,

Lindner³

1995

Eur Urol

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“…Während sich dies in zahlreichen ausländischen Veröffentlichungen widerspiegelt, in denen die URS als ambulanter Eingriff, in Analgosedierung, in Lokalanästhesie, für Kelchsteine, bei multimorbiden adipösen Patienten, bei Kindern und selbst in der Schwangerschaft untersucht wurde [4,5,6,7,8,22,26,38,39,40], hat die deutsche Gesetzgebung bis zur Einführung der DRGs durch die Finanzierung über die Liegedauer solche Entwicklungen nicht in gleichem Maße gefördert. Deshalb ist es nicht verwunderlich, dass es zur URS in Analgosedierung nur wenige deutsche Veröffentlichungen gibt.…”

Section: Ureterorenoskopieunclassified

“…Rittenberg [26] berichtete 1987 über 30 diagnostische Ureterorenoskopien u. a. mit damals gebräuchli-chen starren 10-bis 12-Ch.-Instrumenten. Schow [28] verglich 1994 seine Ureterorenoskopien in Alfentanil-/Midazolam-Analgosedierung (n=30) mit der Spinalanästhesie (n=35) und fand bereits eine signifikante Verkürzung der Aufwachraumzeit von 180 auf 85 min und nahezu eine Halbierung der Anästhesiekosten.…”

Section: Abb 6 ▲ Vergleich Der Schmerzangaben Von Männern Und Frauenunclassified

Die Ureterorenoskopie in Analgosedierung

2004

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In a prospective study, from September 2000 to September 2001, all ureteroscopies ( n=140) were performed under local and intravenous patient controlled analgesia using continuous infusion of remifentanil (Ultiva). The dosage of 0.15 micro g/kg/min was adapted to changing intraoperative pain (range 0.08-0.30 micro g/kg/min). Preoperative sedation with midazolam 2 mg was given 5 min prior to ureteroscopy. The efficacy of monitored anesthesia care ("Big MAC") was quantified by the patient using a visual analogue pain scale. A total of 97.1% (136/140) of the procedures were performed and finished under remifentanil. Only four male patients underwent conversion to general anesthesia due to insufficient analgesia. All but one patient would choose remifentanil again for first line anesthesia. Significant differences in pain scale values were noticed for male/female patients and ureteroscopies above/below the iliac vessel crossing. Side effects were rare being mainly hypoxic events (pO(2)<90% in 5.1%). Indication, intraoperative procedure, average surgery time (24 min), complications and primary success rate (96.6/90/63.3% stone free for distal/mid/proximal ureter, respectively) did not differ from the control group under general anesthesia. Ureteroscopies with remifentanil are safe, universally applicable because of refifentanil's organ independent esterase metabolism and as effective as general anesthesia. There is no need for PACU stay for patients due to the ultra-short drug half-life, and therefore remifentanil is cost effective and perfect in an outpatient setting.

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Ureteroscopy under local anesthesia

Cited by 38 publications

References 11 publications

Safety and Efficacy of Ureteroscopic Lithotripsy for Ureteral Calculi Under Sedoanalgesia – A Prospective Study

Safety and Efficacy of Ureteroscopic Lithotripsy for Ureteral Calculi Under Sedoanalgesia – A Prospective Study

Ureteroscopy for Ureterolithiasis with Sedation Only

Die Ureterorenoskopie in Analgosedierung

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