Comparison of Two Different Anesthesia Methods in Patients Undergoing Percutaneous Nephrolithotomy

Area of Science:

• Urology
• Anesthesiology
• Surgical Outcomes

Background:

• Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stones.
• Anesthesia choice can impact patient outcomes and healthcare costs.

Purpose of the Study:

• To compare the effectiveness, safety, and costs of general anesthesia (GA) versus spinal anesthesia (SA) in PCNL procedures.
• To evaluate key metrics including operation duration, hospitalization, and complication rates.

Main Methods:

• Retrospective analysis of 1657 patients undergoing PCNL between 2009 and 2017.
• Patients were divided into two groups: GA (n=572) and SA (n=1085).
• Comparison of operation time, hospitalization, stone-free ratio, analgesic use, and complications.

Main Results:

• Spinal anesthesia (SA) group had significantly shorter operation times (81.8 min vs. 118.2 min) and hospitalization periods (30.0 hrs vs. 38.4 hrs).
• Post-operative narcotic analgesic need was significantly lower in the SA group (10.9% vs. 33.4%).
• Anesthesia costs were substantially lower with SA (USD 21.3 vs. USD 83.6).
• No significant differences were observed in stone-free ratio or complication rates.

Conclusions:

• Percutaneous nephrolithotomy (PCNL) performed with spinal anesthesia (SA) is a safe and effective alternative to general anesthesia (GA).
• SA offers significant advantages in reduced costs, shorter operation times, and decreased post-operative analgesic requirements.