Shock wave therapy (orthotripsy) is a non-invasive method to treat or ameliorate many musculoskeletal disorders. When higher energies are applied on bones pain is associated with treatment, and anaesthesia is necessary, but there is no need of analgesia after shock wave application. Patients usually receive treatments during a short hospital stay: therefore, short duration drugs and techniques should be preferred, avoiding those causing unpleasant postanaesthetic sequelae. Between February 2002 and October 2004, a series of 136 patients have been treated with orthotripsy requiring some kind of anaesthesia. Anaesthetic techniques and agents suitable for orthotripsy are discussed.