Cardiac dysrhythmias in children undergoing extracorporeal shockwave lithotripsy under general anaesthesia or propofol sedation: a prospective, observational cohort study

To assess the frequency and severity of cardiac dysrhythmias and identify any intraoperative or post-operative complications in children undergoing extracorporeal shock wave lithotripsy (ESWL).

ESWL has been used in adults since 1980 but was not used in children until 1986. The presence of urinary stones in children is reported to range from 0 1% to 0 5% ESWL represents a non-invasive therapy for children with urinary stone disease ESWL in adult practice has been commonly reported to cause cardiac dysrhythmias Previous studies reported no incidence of cardiac dysrhythmias in children

All children coming to our institution for ESWL from June 2014 to January 2015 were prospectively enrolled in an observational cohort study Intraoperative cardiac dysrhythmias as well as perioperative and postoperative complications were recorded

In total, 21 children were enrolled aged 1 to 18 years receiving a total of 26 treatments Intravenous sedation was used in 19 cases and general anaesthesia with an inhalational agent in 7 cases Cardiac dysrhythmias occurred in 58% of children No haemodynamic instability was noted No therapies were terminated due to dysrhythmias and there were no post-operative cardiac dysrhythmias

ESWL remains a safe therapy for children with urinary stone disease Whilst we experienced more dysrhythmias than currently published literature there were no long-term adverse outcomes and children were able to go home the same day

Urology 2015 Jul 22 [Epub ahead of print]

Jonathan D Mathers, Bernadita Solar, Louise Harding, Naima Smeulders, Helen Hume-Smith

Department of Anaesthesia, Great Ormond Street Hospital, London, WC1N 3JH Electronic address: jonathanmathers@me com , Department of Urology, Great Ormond Street Hospital, London, WC1N 3JH , Department of Anaesthesia, Great Ormond Street Hospital, London, WC1N 3JH , Department of Urology, Great Ormond Street Hospital, London, WC1N 3JH , Department of Anaesthesia, Great Ormond Street Hospital, London, WC1N 3JH