Could spinal anesthesia be a choice for retrograde intrarenal surgery

Karabulut, İbrahim; Koç, Erdem; Yılmaz, Ali Haydar; Ahiskali, Elif Oral; Keskin, Ercüment; Adanur, Şenol; Reşorlu, Berkan

doi:10.1177/0391560318758936

Cited by 10 publications

(7 citation statements)

References 17 publications

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“…However, the consistent results of ours and previous reviews ( 12 , 13 ) indicate that such visceral movements have little impact on stone-free rates. Movements can also be restricted under NA by asking the patients to hold their breaths which can facilitate stone disintegration ( 21 ). However, it should be noted that the definition of stone-free status was heterogeneous amongst the included studies with the acceptable cut-off size of remnant stones ranging from 1 to 4 mm.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Retrograde Intrarenal Surgery Performed Under Neuraxial vs. General Anesthesia: An Updated Systematic Review and Meta-Analysis

2022

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BackgroundThe current review aimed to assess if the outcomes of retrograde intrarenal surgery (RIRS) differ with neuraxial anesthesia (NA) or general anesthesia (GA).MethodsThe databases of PubMed, Embase, CENTRAL, ScienceDirect, and Google Scholar were searched up to 3rd December 2021 for randomized controlled trials (RCTs) and observational studies comparing outcomes of RIRS with NA or GA.ResultsThirteen studies involving 2912 patients were included. Eight were RCTs while remaining were observational studies. Meta-analysis revealed that stone free status after RIRS did not differ with NA or GA (OR: 0.99 95% CI: 0.77, 1.26 I2 = 10% p = 0.91). Similarly, there was no difference in operation time (MD: −0.35 95% CI: −4.04, 3.34 I2 = 89% p = 0.85), 24 h pain scores (MD: −0.36 95% CI: −0.96, 0.23 I2 = 95% p = 0.23), length of hospital stay (MD: 0.01 95% CI: −0.06, 0.08 I2 = 35% p = 0.78), Clavien-Dindo grade I (OR: 0.74 95% CI: 0.52, 1.06 I2 = 13% p = 0.10), grade II (OR: 0.70 95% CI: 0.45, 1.07 I2 = 0% p = 0.10) and grade III/IV complication rates (OR: 0.78 95% CI: 0.45, 1.35 I2 = 0% p = 0.37) between NA and GA. Except for grade I complications, the results did not change on subgroup analysis based on study type and NA type.ConclusionOur results suggest that NA can be an alternative to GA for RIRS. There seem to be no difference in the stone-free rates, operation time, 24-h pain scores, complication rates, and length of hospital stay between NA and GA for RIRS. Considering the economic benefits, the use of NA may be preferred over GA while taking into account patient willingness, baseline patient characteristics, and stone burden.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42021295407.

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Section: Discussionmentioning

confidence: 99%

“…Fourteen articles were retrieved for full-text analysis of which one was excluded as it compared peripheral nerve block with GA. Finally, a total of 13 studies were included in this systematic review and metaanalysis (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29).…”

Section: Details Of Included Studiesmentioning

confidence: 99%

Outcomes of Retrograde Intrarenal Surgery Performed Under Neuraxial vs. General Anesthesia: An Updated Systematic Review and Meta-Analysis

2022

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“… 42 If the patient under spinal anaesthesia is cooperative, they can be asked to take shallow breaths or they can be asked to briefly hold their breathing after deep inspiration or deep expiration at certain moments during FURS that need precise action. 43 Giusti et al recommended the use of general anesthesia for the reasons of control of the tidal volume during the surgery and the possible exceeding the time frame of spinal. 12 …”

Section: Anaesthesia Type During Fursmentioning

confidence: 99%

Ergonomics and Surgeon Comfort During Flexible Ureteroscopy

Alnadhari¹,

Ali²,

Abdeljaleel³

et al. 2021

RRU

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The technological advancements of flexible ureteroscopy (FURS) and its accessories have resulted in broadening its indications to include the management of complex renal stones, with long operative time. The surgeon’s understanding about the ergonomics of the ureteroscopes and their cognizance of the operation theatre layout helps to improve their performance, including the surgical outcomes. This paper will describe the ergonomics that are involved in conducting FURS which in turn will aid in developing a more conducive surgical environment for the surgeon during the procedure, based on scientific literature review and expert opinions in high-volume centres. Proper surgeon position, well-arranged operation theatre layout, monitor and pedal position, anaesthesia type, and surgical team are important factors to decrease musculoskeletal strains for surgeons and increase work efficiency. Different types of flexible ureteroscope have different characters and knowing these special characters leads to better ergonomics during surgery. Robotic-assisted FURS have shown good safety and ergonomics in clinical application.

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“…RIRC ilk başlarda genel anestezi altında yapılırken son yıllarda rejyonel anestezi altında da yapılabilir hale gelmiştir. (33)(34)(35) Rejyonel anestezi, termoregülasyonu özellikle periferik düzeyde daha fazla olmak üzere periferik ve santral düzeyde bozmaktadır. (36) Genel anestezide ise hem periferik hem de santral termoregülasyon bozulmakta ve daha fazla soğuma ortaya çık-maktadır.…”

Section: Gereç Ve Yöntemlerunclassified

Retrograd İntrarenal Cerrahi Esnasında Oluşan Vücut Sıcaklık Değişikliklerini Etkileyen Faktörler

Guzelburc

Soytaş

Kiremit

et al. 2020

Yeni Üroloji Dergisi

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Retrograd intrarenal cerrahi (RIRC) esnasında diğer endoürolojik operasyonlardan farklı olarak daha düşük debi ve hacimde irrigasyon sıvısı kullanılmaktadır. Çalışmamızda kullanılan irrigasyon sıvısına bağlı olarak vücutta oluşan sıcaklık değişiklikleri ve buna etki eden faktörler incelendi. Gereç ve Yöntemler: Prospektif olarak çalışmaya 128 hasta dahil edildi. Operasyonlarda standart olarak 21°C ameliyathane odasında bulundurulan izotonik irrigasyon sıvısı kullanıldı. Hiçbir hastaya aktif ısıtma uygulanmadı. Hastaların ateşi anestezi indüksiyonu öncesinde ve uyandırma öncesinde periferik yoldan ölçüldü. Ölçülen vücut sıcaklık farklarının hasta özellikleri, operasyon süresi, kullanılan irrigasyon sıvısı hacmi ve taş büyüklüğüyle ilişkisi değerlendirildi. Bulgular: Operasyona girişte timpanik ortalama vücut sıcaklığı 36,3±0,35°C iken operasyon sonunda 35,8±0,5°C hesaplandı. Hastaların 102'sinde (%79,7) post-op vücut sıcaklık düşüşü (0,67±0,47°C) kaydedildi. Operasyon öncesi ve sonrasındaki vücut sıcaklık değerleri karşılaştırıldığında anlamlı düşüş saptandı (p<0,0001). Bu düşüş ile hasta ve operatif veriler arasında istatistiksel anlamlı bir ilişki saptanmadı. Sonuç: RIRC sonrasında vücut sıcaklığı düşmektedir ancak ameliyathane oda sıcaklığı dışındaki hasta ve operatif verilerle ateş değişimi arasında ilişki kurulamamıştır.

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Could spinal anesthesia be a choice for retrograde intrarenal surgery

Cited by 10 publications

References 17 publications

Outcomes of Retrograde Intrarenal Surgery Performed Under Neuraxial vs. General Anesthesia: An Updated Systematic Review and Meta-Analysis

Outcomes of Retrograde Intrarenal Surgery Performed Under Neuraxial vs. General Anesthesia: An Updated Systematic Review and Meta-Analysis

Ergonomics and Surgeon Comfort During Flexible Ureteroscopy

Retrograd İntrarenal Cerrahi Esnasında Oluşan Vücut Sıcaklık Değişikliklerini Etkileyen Faktörler

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