J Korean Pain Soc.  1989 May;2(1):21-25.

Continuous Epidural Analgesia of Lidocaine and Morphine for the Management of Ureteral Calculi

• Cho GL
• Hur NJ
• Roh US
• Cho SK
• Lee SH

Abstract

For the simple operations of the perineal region, caudal, epidural and saddle blocks of analgesia are preferable anesthesia techniques in men. But, if the operations shoud be delayed or the physicians are willing to observe and manipulate the patients for a couple of days, as in the ureteral stone manipulation, continuous epidural analgesia will be a reliable method. The authors have observed 36 male patients of ureteral calculi with continuous lumbar epidural analgesia for the purpose of elimination of an undesirable pain sensation which was associated with the transurethral cystoscopic manipulation. The results were as follows: 1) In most cases, the anesthetics used were 1% lidocaine 20 ml through the L3-4 and L4-5, interspace with 4-6 cm of catheter tip advancement mainly to cephalad. 2) There was no motor weakness or paralysis in the lower extremities except some numbness and paresthesia on the perineal area. 3) Besides the various minor complications, there were no problems in respiration with small doses of morphine extradurally. 4) Among them, four cases of ureteral calculi dropped into the bladder spontaneously due to the epidural technique during transportation of the patients from the pain clinic to the urology out-clinic. One case of calculi was dropped by the aid of instrumentation at the ward, and twelve cases of calculi were removed directly by Dormia stone basket in the scopic room. For the remaining patients, we deduced that their calculi was be evacuated out because there were no complaints were notified after discharge.

MeSH Terms

Analgesia
Analgesia, Epidural*
Anesthesia
Anesthetics
Calculi
Catheters
Humans
Hypesthesia
Lidocaine*
Lower Extremity
Male
Morphine*
Pain Clinics
Paralysis
Paresthesia
Respiration
Sensation
Transportation
Ureter*
Ureteral Calculi*
Urinary Bladder
Urology
Anesthetics
Lidocaine
Morphine