Ureteroscopy under spinal versus general anaesthesia: morbidity and stone clearance

To compare morbidity and stone clearance by ureteroscopy carried out under spinal anaesthesia with that carried out under general anaesthesia.

Quasi-experimental study.

The study was conducted at the Kidney Centre, Postgraduate Training Institute, Karachi, from September 2005 to December 2006.

A total number of 60 patients were enrolled for the study. All patients underwent ureteroscopic procedure for a calculus disease, using a semi-rigid ureteroscope of 10 Fr. These patients were divided in 2 groups of 30 patients, receiving general or spinal anaesthesia. Operative time, stone clearance, hospital stay, intra- and postoperative complications and visual analogue score for pain were noted in each case.

There were 30 patients each in both groups, with 73% males and 27% females in group A (general anaesthesia) and 93% males and 7% females in group B (spinal anaesthesia). Mean age of the patients were 33.9 and 36.9 years in groups A and B respectively. The average stone size was 0.79 cm in group A and 1.14 cm in group B (p=0.001). Duration of surgery was 41.4+/-1.29 minutes in group A and 30.5+/-2.13 minutes in group B (p=0.033). Mean hospital stay was 21.6 and 18.1 hours in group A and B respectively (p=0.073). Mean visual analogue score for pain in group A was 3.1 and group B was 1.8.

Ureteroscopy under spinal anaesthesia resulted in decreased length of operative time and shortened hospital stay in this series and did not carry any additional risk of major complications.