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General Anesthesia: Overview

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...

Local Anesthetics: Clinical Application as Spinal Anesthesia

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...

Local Anesthetics: Clinical Application as Epidural Anesthesia

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...

Stages of General Anesthesia

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...

Parenteral Anesthetics: Overview

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...

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Related Experiment Video

Updated: May 13, 2026

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Published on: January 31, 2025

General versus spinal anesthesia in percutaneous nephrolithotomy.

Sadrollah Mehrabi¹, Ali Mousavi Zadeh, Mehdi Akbartabar Toori

¹Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran. sadrollahm@yahoo.com

Urology Journal

|March 19, 2013

Summary

Spinal anesthesia is a safe and cost-effective alternative to general anesthesia for percutaneous nephrolithotomy (PCNL). While it may increase certain complications, it significantly reduces costs and narcotic use during PCNL procedures.

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Area of Science:

Urology
Anesthesiology

Background:

Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
Anesthesia choice impacts patient outcomes and procedure costs.

Purpose of the Study:

To compare the efficacy and complication rates of spinal anesthesia versus general anesthesia in patients undergoing PCNL.
To evaluate the cost-effectiveness of different anesthesia methods for PCNL.

Main Methods:

A prospective randomized study involving 110 patients undergoing PCNL.
Patients were assigned to either general anesthesia (n=52) or spinal anesthesia (n=58) using bupivacaine and fentanyl.
Complications, intra-operative parameters, and drug costs were recorded and analyzed.

Main Results:

Spinal anesthesia was associated with increased intra-operative hypotension, postoperative headache, and low back pain compared to general anesthesia (P < .05).
Narcotic medication requirements and anesthetic drug costs were significantly lower in the spinal anesthesia group (P = .03 and P = .001, respectively).
No neurological complications were observed in either group.

Conclusions:

Spinal anesthesia, combined with bupivacaine and fentanyl, is a safe and effective anesthetic option for PCNL in adult patients.
This method offers significant cost savings compared to general anesthesia for PCNL.
Despite a potential increase in minor complications, spinal anesthesia presents a favorable risk-benefit profile for PCNL.