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

Abstract

Objective: To compare the efficacy and safety of regional epidural anesthesia and general anesthesia in patients who underwent PCNL. Materials and Methods: Fifty patients submitted to percutaneous nephrolithotomy (PCNL) were randomized into two groups: Group I (N = 26) received general anesthesia and Group II (N = 24) received regional epidural anesthesia. Demographic and operative data including age, BMI, stone position, stone size, postoperative pain, amount of postoperative analgesic usage, length of hospital stay, patient satisfaction, preoperative and postoperative hemoglobin and hematocrit, adverse effects and surgical complications were compared between both groups.

A comparative study of combined spinal epidural anaesthesia and general anaesthesia in patients undergoing percutaneous nephrolithotomy

“…11,18,25,26,28 Karacalar Serap et al studied 180 patients undergoing PCNL, concluded that CSE gave greater patient satisfaction, shorter times for PACU and home readiness, and less postoperative pain (p = 0.001). 20 Elbeally et al conducted a study on 57 patients undergoing PCNL in GA, epidural anaesthesia (EA) and paravertebral block (P).…”

“…Similar to our study Tangpaitoon et al, Karacalar Serap et al, Elbealy et al found increase in incidence of PONV in GA group as compared to CSE. 20,21,26 …”

Effect of Epidural Analgesia in the Peri-Operative Haemodynamic Changes and Recovery Profile in Patients Undergoing Percutaneous Nephrolithotomy under General Anesthesia

“…The post operative pain as assessed by VAS showed that 34 patients had mild pain and 16 had moderate pain in Group 2(C), while most patients had no pain and only 13 patients had mild pain in Group 1(E) [Table 13a,13b,13c]. This difference in VAS is statistically significant and shows that effective analgesia is achieved with epidural Ropivacaine (11) . Other complications in recovery included shivering and hypertension which were more in Group (C).…”

“…It has vasoconstrictive properties at these concentrations which may explain its longer duration compared to Bupivacaine (7) . Sensory block with Ropivacaine is similar to Bupivacaine (8) but Ropivacaine showed greater separation of sensory and motor block (9), (10) and better patient satisfaction (11) . Studies have also showed that Ropivacaine is effective for intraoperative and postoperative analgesia in patients undergoing PCNL (12), (13), (14) .…”

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 .…”