Comparison of general anesthesia and combined spinal-epidural anesthesia for retrograde intrarenal surgery

Çakıcı, Mehmet Çağlar; Özok, Uğur; Erol, Demet Doğan; Çatalca, Sibel; Sarı, Sercan; Özdemir, Hatice; Selmï, Volkan; Kartal, İbrahim; Karakoyunlu, Nihat

doi:10.23736/s0393-2249.19.03481-7

Cited by 18 publications

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“…However, they found no significant difference in terms of pain on the second postoperative day. Kim et al (14) and Cakici et al (12) found no difference in pain levels between the two different anesthesia types during RSS. In our study, we found no significant difference between GA and RA in terms of postoperative pain among patients undergoing f-URS procedure.…”

Section: Discussionmentioning

confidence: 96%

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Flexible ureterorenoscopy and laser lithotripsy with regional anesthesia vs general anesthesia: A prospective randomized study

et al. 2020

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Purpose: To compare the effect of general anesthesia (GA) and regional anesthesia (RA) on fURS outcomes and surgeon comfort. Material and Methods: The study was conducted between June 2017 to January 2018 and data collection was applied in a prospective, randomized fashion. 120 patients participated in the study and were divided into RA group (n=56) and GA group (n=64). Demographic, operative and post-operative parameters of patients were analysed. The end point of this study was the effect of two anesthesia regimens on the comfort of the surgeon, and the comparability of feasibility and safety against perioperative complications. Results: The study including 120 randomized patients, 14 patients were excluded from the study and completed with 106 patients (45 in RA group and 61 in GA group). No difference was detected between the two groups in terms of preoperative data. During the monitorization of operative vital signs, 3 patients in RA group experienced bradycardia, and this finding was significant when compared with GA group (p=0.041). Additionally, 2 patients in RA group experienced mucosal tears and 1 patient experienced hemorrhage during the operation, but no complications were observed in the GA group (p=0.041). Postoperative surgeon comfort evaluation revealed statistically significant results in favor of GA group (p=0.001). Conclusions: Both GA and RA are equally effective and safe anesthesia methods for fURS procedures. However, RA group showed significantly increased likelihood of bradycardia and mucosal injury during surgery, and significantly decreased surgeon comfort during surgery.

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Section: Discussionmentioning

confidence: 96%

“…General anesthesia is the preferred anesthesia type for f-URS in majority of studies in the literature (5,6,8,12). RA has been shown to be safe and effective in the treatment of renal stones in PNL procedure.…”

Section: Discussionmentioning

confidence: 99%

Flexible ureterorenoscopy and laser lithotripsy with regional anesthesia vs general anesthesia: A prospective randomized study

et al. 2020

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“…In our study, spinal and epidural anesthesia were generally used for RIRS. There are studies comparing three types of anesthesia in RIRS (18,19). The appropriate anesthesia method is chosen according to the surgeon, anesthesiologist and patient features.…”

Section: Methodsmentioning

confidence: 99%

Multikalisiyel ve Multiple Böbrek Taşlarının Tedavisinde Retrograd İntrarenal Cerrahi Deneyimimiz

Sarı

Selmï

Caniklioğlu

et al. 2020

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

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Objective: Multiple kidney stones are seen in 20-25% of the patients. Treatment of multiple kidney stones is challenging.Retrograde intrarenal surgery is used in the treatment of multiple kidney stones. Success is lower than the single stones of the same size. We aimed to report our retrograde intrarenal surgery experience in the treatment of multi-caliceal and multiple kidney stones. Material and Methods: After approval of local ethics committee, patient data between 01.01.2014-01.01.2019 were retrospectively analyzed. Patients who had undergone retrograde intrarenal surgery for multi-caliceal and multiple kidney stones were included in our study. Demographic, intraoperative and postoperative data and complications were recorded. Results: Forty-three patients were included in our study. The mean stone size was 13.69±6.21 mm. Mean stone volume was 972.48 ± 905.24 mm 3 . Mean Hounsfield unit was 1128.26±317.91 HU. The mean operation time was 51.97±20.18 minutes. Thirty-two patients were stone free. Postoperative complications were seen in four patients. Mucosal injury was observed in one patient and urinary tract infection was observed in three patients. Conclusion: Multi-caliceal and multiple kidney stone treatment is challenging for urologists. There are various treatment methods. Retrograde intrarenal surgery is a safe and efficient alternative for the treatment of multi-caliceal and multiple kidney stones. Prospective and larger cohort studies are needed. Amaç: Multiple böbrek taşları % 20-25 hastada görülmektedir. Tedavisi zordur. Retrograd intrarenal cerrahi multiple böbrek taşı tedavisinde kullanılmaktadır. Başarı aynı boyuttaki normal taşlara göre düşüktür. Biz çalışmamızda kliniğimizdeki multiple taş tedavisinde retrograd intrarenal cerrahi deneyimimizi sunmayı amaçladık. Gereç ve Yöntemler: Lokal etik kurul onayı alındıktan sonra 01.01.2014-01.01.2019 arası hasta verileri retrospektif olarak tarandı. Multikaliseal ve multiple böbrek taşı için retrograd intrarenal cerrahi yapılan hastalar çalışmaya alındı. Onsekiz yaş altındaki hastalar çalışmadan çıkarıldı. Demografik, intraoperatif, postoperatif veriler ve komplikasyonlar kaydedildi. Bulgular: Çalışmaya 43 hasta alındı. Taş boyutu ortalama 13.69±6.21 mm idi. Taş volümü ortalama 972.48 ± 905.24 mm 3 , Hounsfield ünitesi ortalama 1128.26±317.91 HU idi. Ortalama operasyon zamanı 51.97±20.18 dakikaydı. Taşsızlık 32 hastada sağlandı. Postoperatif komplikasyonlar dört hastada görüldü. Bir hastada mukozal yaralanma, üç hastada idrar yolu enfeksiyonu izlendi. Sonuç: Multikaliseal ve multiple böbrek taş tedavisi ürologlar için zorludur. Çeşitli tedavi yöntemleri mevcuttur. Retrograd intrarenal cerrahi güvenli ve etkin bir alternatiftir. Prospektif ve yüksek hasta sayılı çalışmalara ihtiyaç vardır.

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“…[ 23 ] Although most urologists prefer GA for endoscopic renal surgery, RA has equivalent efficacy and safety outcomes with possibly reduced operative time, hospitalization stay, blood transfusion rates, and postoperative pain without compromising stone clearance rates. [ 24 25 26 27 ]…”

Section: Anesthesia Considerationsmentioning

confidence: 99%

Changing urological practice during COVID-19

et al. 2020

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Comparison of general anesthesia and combined spinal-epidural anesthesia for retrograde intrarenal surgery

Cited by 18 publications

References 18 publications

Flexible ureterorenoscopy and laser lithotripsy with regional anesthesia vs general anesthesia: A prospective randomized study

Flexible ureterorenoscopy and laser lithotripsy with regional anesthesia vs general anesthesia: A prospective randomized study

Multikalisiyel ve Multiple Böbrek Taşlarının Tedavisinde Retrograd İntrarenal Cerrahi Deneyimimiz

Changing urological practice during COVID-19

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