Extra-Corporeal Shock Wave Lithotripsy for Renal and Upper Ureteral Stones in Adults Under Locally Infiltrate d Anaesthetics ; a Clinical Randomized Controlled Study

which patients will undergo ESWL under locally infiltrated anaesthetic. Using ultrasound guidance, the quadratus lumborum muscle will be identified. Then a mixture of 0.5 % bupivacaine (10 ml) and 2 % lidocaine (10 ml) will be injected into the muscle as a single shot 20 minutes before the procedure.

"which patients will undergo ESWL under systemic analgesia. The latter will be achieved using one gram of paracetamol IV infusion at the beginning of the procedure.~In case of unsatisfactory pain control in either group, systemic analgesia using IV Ketorolac injection will be used on demand or the required dose will be recorded at the end of the session."