Clinical efficacy of flexible ureteroscopic lithotripsy under local anesthesia and risk factors of perioperative pain
10.3969/j.issn.1009-8291.2023.11.015
- VernacularTitle:局麻输尿管软镜碎石术治疗上尿路结石疗效及围手术期疼痛的危险因素
- Author:
Ning WANG
1
;
Huiqian LIU
1
;
Junjie YAO
1
;
Zhenyu LIU
1
;
Yongxi TANG
1
;
Zhikang YIN
1
Author Information
1. Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
- Publication Type:Journal Article
- Keywords:
flexible ureteroscopy;
upper urinary tract calculi;
local anesthesia;
pain;
visual analogue score;
influencing factors
- From:
Journal of Modern Urology
2023;28(11):988-992
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To explore the efficacy of flexible ureteroscopic lithotripsy (FURL) under local anesthesia (LA) in the treatment of upper urinary tract calculi, and to analyze the risk factors of pain. 【Methods】 Clinical data of 255 patients treated during Apr.2022 and Sep.2022 were reviewed, including visual analogue score (VAS) of pain during ureteroscopy, sheath placement, holmium laser lithotripsy, 1 hour and 8 hours after operation. VAS ≥5 was defined as significant pain. Clinical and follow-up data of the significant pain group and non-significant pain group were analyzed with logistic regression to analyze the risk factors of pain in FURL under LA. 【Results】 Altogether 198 patients (77.6%) successfully completed the operation, and the stone-free rate (SFR) was 89.9% (178/198). The VAS of ureteroscopy was the highest (4.49±1.08), and 73 patients (28.6%) experienced significant pain. Univariate analysis showed that significant pain was associated with gender, previous surgical history, age, body mass index (BMI), education level, and ASA classification (P<0.05). Multivariate analysis showed that male (OR=2.896, 95%CI:1.413-5.933, P=0.040) and BMI≥28 (OR=7.776, 95%CI:2.268-26.657, P=0.001) were independent risk factors of significant pain, while age ≥65 years (OR=0.237, 95%CI:0.083-0.672, P=0.007) and previous surgical history (OR=0.156, 95%CI:0.032-0.754, P=0.021) were the protective factors. 【Conclusion】 It is feasible and effective to treat upper urinary tract calculi with FURL under LA. The presence of significant pain is associated with factors such as gender, age, BMI and previous surgical history.
