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Transient Apnea During Flexible Ureteroscopic Lithotripsy
Sponsor: Chinese Medical Association
Summary
Respiration-related renal motion may reduce targeting stability during flexible ureteroscopic laser lithotripsy and thereby decrease lithotripsy efficiency. This single-center, three-arm randomized controlled trial evaluated whether transient apnea during active lithotripsy could improve lithotripsy efficiency while maintaining short-term physiologic safety. A total of 150 patients undergoing flexible ureteroscopic lithotripsy for renal stones were randomized in a 1:1:1 ratio to regular mechanical ventilation, small tidal-volume ventilation, or transient apnea. The primary outcome was active lithotripsy efficiency, defined as CT-based stone volume divided by active lithotripsy time. Physiologic safety was assessed using serial arterial blood gas measurements at baseline, 3, 6, and 9 minutes during the lithotripsy phase and 3 minutes after resumption of ventilation, together with continuous intraoperative cardiopulmonary monitoring.
Official title: Transient Apnea to Stabilize Renal Motion During Flexible Ureteroscopic Lithotripsy: A Randomized Controlled Trial of Efficiency and Physiological Safety
Key Details
Gender
All
Age Range
18 Years - 80 Years
Study Type
INTERVENTIONAL
Enrollment
150
Start Date
2020-06-15
Completion Date
2025-04-16
Last Updated
2026-06-15
Healthy Volunteers
No
Conditions
Interventions
Regular mechanical ventilation during flexible ureteroscopic lithotripsy
Standard controlled mechanical ventilation was maintained during the active lithotripsy phase according to routine anesthetic practice.
Small tidal-volume ventilation during flexible ureteroscopic lithotripsy
Controlled ventilation with a reduced tidal-volume strategy was applied during active lithotripsy under continuous anesthetic monitoring.
Transient apnea during flexible ureteroscopic lithotripsy
Transient apnea was applied during active laser lithotripsy to reduce respiration-related renal motion. Apnea was initiated after adequate preoxygenation and confirmation of physiologic stability. Apnea was terminated if SpO₂ was \<90%, systolic blood pressure was \>160 mmHg or \<80 mmHg, heart rate was \<50 beats/min, obvious arrhythmia occurred, hemodynamic instability developed, or the attending anesthesiologist had any safety concern.
Locations (1)
Changhai Hospital, Naval Medical University
Shanghai, Shanghai Municipality, China