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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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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...
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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.
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Comparing Spinal and General Anesthesia for Prone Percutaneous Nephrolithotomy: A Propensity Score-Matched Study.

Lingjun Chen, Dian Xu, Lulu Hou

    Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre
    |May 4, 2026
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    Prone percutaneous nephrolithotomy (PCNL) under spinal anesthesia (SA) is as effective as general anesthesia (GA) for kidney stones. SA offers shorter surgery and hospital stays with similar stone-free and complication rates.

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    Area of Science:

    • Urology
    • Anesthesiology
    • Nephrology

    Background:

    • Prone percutaneous nephrolithotomy (PCNL) is typically done under general anesthesia (GA).
    • Spinal anesthesia (SA) is emerging as a feasible alternative for PCNL.
    • This study evaluates the safety and efficacy of prone PCNL under SA.

    Purpose of the Study:

    • To compare postoperative complications and stone-free rates (SFR) of prone PCNL under SA versus GA.
    • To assess operative parameters and hospital stay for PCNL performed under SA.

    Main Methods:

    • A retrospective study of 778 patients undergoing prone PCNL by a single surgeon.
    • Patients were divided into general anesthesia (GA) and spinal anesthesia (SA) groups.
    • Propensity score matching (PSM) was used to compare outcomes between 280 patients in each group.

    Main Results:

    • No significant differences in stone characteristics or operative parameters like fluoroscopy time.
    • Spinal anesthesia (SA) group showed significantly shorter surgery duration, anesthesia duration, and hospital stay.
    • Comparable stone-free rates and overall postoperative complication rates between SA and GA groups, with no life-threatening complications.

    Conclusions:

    • Prone PCNL under spinal anesthesia (SA) is safe and effective.
    • SA achieves comparable stone-free and complication rates to general anesthesia (GA).
    • SA offers benefits of shorter operative time and hospital stay for PCNL.