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Published on: January 31, 2025
Spinal anesthesia is an efficient and safe anesthetic method for percutaneous nephrolithotomy
Tufan Cicek1, Umut Gonulalan1, Rafi Dogan2
1Department of Urology, Baskent University, School of Medicine, Konya, Turkey.
Spinal anesthesia (SA) for percutaneous nephrolithotomy (PCNL) resulted in shorter hospital stays and operation times compared to general anesthesia (GA). SA is a safe and effective alternative for select PCNL patients, with fewer complications.
Area of Science:
- Urology
- Anesthesiology
- Surgical Outcomes
Background:
- Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
- The choice of anesthesia, spinal anesthesia (SA) or general anesthesia (GA), may impact PCNL outcomes.
- Optimizing anesthesia for PCNL is crucial for patient safety and procedural efficiency.
Purpose of the Study:
- To compare the safety and efficiency of spinal anesthesia (SA) versus general anesthesia (GA) in patients undergoing percutaneous nephrolithotomy (PCNL).
- To evaluate the impact of anesthesia type on operative time, hospitalization, and complication rates in PCNL procedures.
Main Methods:
- Retrospective analysis of 1004 adult patients who underwent PCNL between 2004 and 2011.
- Patients were divided into two groups: general anesthesia (GA, n=564) and spinal anesthesia (SA, n=440).
- Comparison of operative and postoperative outcomes, including complication rates using the modified Clavien classification.
Main Results:
- Spinal anesthesia (SA) group showed significantly shorter hospitalization, operation, and fluoroscopy durations compared to the general anesthesia (GA) group (P < .01).
- The GA group experienced a significantly higher requirement for postoperative narcotic analgesics and blood transfusions (P < .01).
- More grade 2, 3a, 3b, and 4b complications were observed in the GA group (P < .05).
Conclusions:
- Percutaneous nephrolithotomy (PCNL) performed with spinal anesthesia (SA) is associated with reduced hospitalization, operation, and fluoroscopy times.
- General anesthesia (GA) for PCNL is linked to increased needs for narcotic analgesics and a higher frequency of major complications.
- Spinal anesthesia (SA) is a safe and effective anesthetic choice for appropriately selected patients undergoing PCNL.
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