Objective: The perioperative stress response of patients who were planned to have percutaneous nephrolithotomy under epidural anesthesia with opioids and local anesthetics has not been investigated in detail yet. Our hypothesis is that the stress response following percutaneous nephrolithotomy can be lessened by epidural analgesia. Methods:A total of 48 patients, between 18-65 years of age and ASA I-II, in whom elective percutaneous nephrolithotomy was planned, were randomly divided into two groups as follows. Group GA (n = 24): general anesthesia by sevoflurane and fentanyl and postoperative intravenous PCA; Group GE (n = 24): epidural anesthesia and general anesthesia together with postoperative epidural analgesia (0.125% levobupivacaine+fentanyl). Blood levels for glucose, insulin, prolactin and cortisol were evaluated prior to anesthesia, after surgical incision, immediately following percutaneous dilatation and postoperative 24 th hour. Intraoperative hemodynamic parameters and postoperative pain scores together with preoperative and postoperative hematocrit values were recorded.Results: Postoperative pain scores were found to be statistically significantly lower (p < 0.05) in Group GE at all measurement times. Intraoperative blood loss was statistically significantly lower in Group GE (p = 0.011). When hemodynamic parameters were compared, at all time intervals except baseline measurement, blood pressure and heart rate were significantly lower in Group GE (p < 0.05). Levels of stress hormones, glucose, cortisol, insulin and prolactin remained significantly lower in Group GE. Conclusion:We think that epidural anesthesia, performed in addition to general anesthesia, may be a comfortable anesthesia method with its suppressive effects on intraoperative and postoperative stress response together with reduced pain scores in the postoperative period.