Percutaneous Nephrolithotomy Under General Versus Combined Spinal-Epidural Anesthesia

Abstract

We consider that combined spinal-regional anesthesia is a feasible technique in PCNL operations because the efficacy and safety were not affected. Further investigations with larger series are needed.

Efficacy and safety of percutaneous nephrolithotomy (PCNL): a prospective and randomized study comparing regional epidural anesthesia with general anesthesia

“…Recently PCNL under regional spinal anesthesia was reported to gain benefits because regional spinal anesthesia achieves better postoperative quality of life due to earlier postoperative recovery but most reports were not part of the controlled study (4,5). Singh et al (6) reported a prospective randomized study comparing PCNL under general anesthesia with PCNL under spinal epidural anesthesia.…”

“…Nowadays, PCNL is usually performed under general anesthesia due to better control of breathing and more comfort for the patients. However, there are some occasionally side effects from general anesthesia such as lung atelectasia, drug allergy and postoperative nausea and vomiting (4,5). Recently, PCNL under epidural anesthesia was reported as having some advantage over general anesthesia, such as lower post operative pain, lower dose requirement for analgesic drugs, and avoidance of the side effects from multiple medication during general anestheVol.…”

“…Recently, PCNL under epidural anesthesia was reported as having some advantage over general anesthesia, such as lower post operative pain, lower dose requirement for analgesic drugs, and avoidance of the side effects from multiple medication during general anestheVol. 38 (4): 504-511, July - August, 2012 sia (4)(5)(6). The aim of this study was to compare the efficacy and safety of regional epidural anesthesia and general anesthesia in patients who underwent PCNL.…”

Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

“…They found the stone-free rate in the general anesthesia group was 71.37%, similar to the spinal anesthesia group 72.97% (p > 0.05) 35 . Kuzgunbay et al 36 and Tangpaitoon et al 37 also found that combined spinal-regional anesthesia is a feasible technique in PCNL operations because the efficacy and safety were not affected compared to PCNL with general anesthesia. Selection of anesthesia is important because it can affect the patient's postoperative recovery and a consideration for the urologist to discharge a patient from the hospital in a safe condition as soon as possible 38 .…”

“…In our study, the majority of PCNL was performed under spinal anesthesia (81.4%) and no conversion from spinal to general anesthesia was recorded. It was found that the use of spinal anesthesia can reduce the need for PCNL postoperative analgetic, decrease nausea 39 , and the patient can cooperate when operation being held 36 . General anesthesia on the other hand, may increase complications in PCNL when the patient changes position 40 .…”