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Regional versus General Anesthesia for Percutaneous Nephrolithotomy: A Meta-Analysis
Henglong Hu1, Baolong Qin1, Deng He1
1Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Plos One
|May 12, 2015
Summary
Regional anesthesia (RA) offers benefits for percutaneous nephrolithotomy (PNL), including shorter operative times and reduced pain. However, both RA and general anesthesia (GA) are effective and safe for PNL patients.
Area of Science:
- Urology
- Anesthesiology
- Evidence-Based Medicine
Background:
- Percutaneous nephrolithotomy (PNL) is a key procedure for kidney stone removal.
- The choice of anesthesia, regional anesthesia (RA) or general anesthesia (GA), impacts patient outcomes.
Purpose of the Study:
- To compare the effectiveness and safety of RA versus GA for PNL.
- To synthesize current evidence on anesthesia techniques for PNL.
Main Methods:
- Systematic literature search of PubMed, EMBASE, Cochrane Library, and Web of Knowledge.
- Meta-analysis of 8 randomized controlled trials (RCTs) and 6 non-randomized controlled trials (nRCTs) involving 2270 patients.
Main Results:
- RA was associated with shorter operative time, reduced postoperative pain and analgesic requirements, shorter hospitalization, and fewer severe complications compared to GA.
- RA also showed a trend towards less blood transfusion and fever.
- Intraoperative hypotension was more frequent with RA, while no significant difference was found in total postoperative complications or stone-free rates.
Conclusions:
- Both RA and GA are safe and effective for PNL in selected patients.
- RA offers several advantages, but further research is needed to clarify certain aspects.
- Patient selection is crucial for optimizing anesthesia outcomes in PNL.
