URETEROSCOPY UNDER LOCAL-ANESTHESIA WITH AND WITHOUT INTRAVENOUS ANALGESIA

In a prospective study of 302 ureteroscopic procedures, 161 were comme nced and 133 completed without the use of general or regional anaesthe sia. In 15 patients ureteroscopy (URS) was performed with lignocaine j elly in the urethra only, and in 1 18 with additional intravenous anal gesia. Alfentanil, a synthetic morphine derivative, was used for intra venous analgesia. Ureteroscopy was performed prior to extracorporeal s hock wave lithotripsy in 46 patients, for stone basketing in 40, for s tone fragmentation in 29, for diagnostic purposes in 14 and for cold k nife ureterotomy in 4. Ureteric lesions were observed in 9 patients (6 .8%) treated under intravenous sedoanalgesia. This percentage is withi n the range reported in other series of patients treated under general anaesthesia. The findings suggest that URS, when performed without ge neral or regional anaesthesia, does not increase the risk of complicat ions or compromise the results of treatment.