Comparison between spinal and general anesthesia in percutaneous nephrolithotomy.

Area of Science:

• Urology
• Anesthesiology
• Nephrology

Background:

• Hemodynamic stability and blood loss are critical considerations in percutaneous nephrolithotomy (PNCL).
• Optimizing anesthetic techniques for PNCL remains an area for further investigation.

Purpose of the Study:

• To compare the efficacy and safety of spinal anesthesia (SA) versus general anesthesia (GA) in patients undergoing PNCL.
• To evaluate hemodynamic stability, blood loss, and analgesic requirements between SA and GA.

Main Methods:

• A randomized clinical trial involving 59 patients undergoing PNCL, divided into SA (n=29) and GA (n=30) groups.
• Standardized anesthetic protocols were administered for both groups, with detailed recording of hemodynamic parameters (MAP, heart rate).
• Surgical and anesthesia times, blood loss, and analgesic consumption were measured.

Main Results:

• No significant differences in mean arterial pressure (MAP) or heart rate were observed between the SA and GA groups.
• The SA group demonstrated significantly reduced surgery time, anesthesia time, bleeding volume, and analgesic intake compared to the GA group (P < 0.05).

Conclusions:

• Spinal anesthesia (SA) is a safe and effective alternative to general anesthesia (GA) for percutaneous nephrolithotomy (PNCL).
• SA offers advantages including decreased blood loss, reduced analgesic requirements, and shorter operative and anesthesia durations.
• Patients undergoing PNCL with SA exhibit stable hemodynamics during surgery and recovery.