Comparison of Two Ventilation Techniques During General Anesthesia for Extracorporeal Shock Wave Lithotripsy: High-Frequency Jet Ventilation Versus Spontaneous Ventilation with a Laryngeal Mask Airway

Objectives

To compare high-frequency jet ventilation (HFJV) with spontaneous ventilation (SV) in general anesthesia for extracorporeal shock wave lithotripsy (ESWL).

Methods

We conducted a retrospective review of 91 consecutive patients undergoing either HFJV with a Ben Jet airway or SV with a laryngeal mask airway, comparing the total number of shocks for stone ablation and the time in the post-anesthetic care unit between groups. Stone ablation rates on postoperative x-rays were compared.

Results

The HFJV group needed significantly fewer shocks for stone ablation (median, 2000 versus 3000, P = 0.0001), and there was no difference in post-anesthetic care unit time. No patient in either group had significant clinical signs of ESWL-related tissue trauma. There was no difference in stone ablation rates on follow-up x-ray (HFJV 77% versus SV 74%).

Conclusions

This study supports the use of HFJV as a ventilation mode for ESWL when general anesthesia is chosen. Similar stone fragmentation rates can be achieved with fewer shocks, which may have beneficial effects, such as less pain and nausea, requiring further study.