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Abstract
To compare the efficacy and safety of regional epidural anesthesia and general anesthesia in patients who underwent PCNL. 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. Average pain score at 1 hour. was 6.88 in group I and 3.12 in group II (p < 0.001), at 4 hours. 5.07 in group I and 3.42 in group II (p = 0.025). Less morphine was required in the regional epidural anesthesia group compared to the general anesthesia group. Higher satisfaction was found in the regional epidural group. 6 (23.07 %) patients in Group I and 1 patient (4.19 %) in Group II had postoperative nausea and vomiting, respectively (p = 0.05). Pain score at 12 hours, 24 hours, 48 hours, 72 hours, preoperative and postoperative hemoglobin and hematocrit, length of hospital stay, and adverse effects were no different between the two groups. Regional epidural anesthesia is an alternative technique for PCNL which achieves more patient satisfaction, less early postoperative pain and less adverse effects from medication with the same efficacy and safety compared to general anesthesia.
Highlights
Percutaneous nephrolithotomy (PCNL) is the treatment of choice for large renal calculi, staghorn calculi and calculi which fail treatment with extracorporeal shockwave lithotripsy and ureteral endoscopy [1,2,3]
percutaneous nephrolithotomy (PCNL) can be performed under general anesthesia, regional anesthesia or local anesthesia
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 anestheibju | Efficacy and safety of percutaneous nephrolithotomy (PCNL): a prospective and randomized study sia [4,5,6]
Summary
To compare the efficacy and safety of regional epidural anesthesia and general anesthesia in patients who underwent PCNL. 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. Less morphine was required in the regional epidural anesthesia group compared to the general anesthesia group. Pain score at 12 hours, 24 hours, 48 hours, 72 hours, preoperative and postoperative hemoglobin and hematocrit, length of hospital stay, and adverse effects were no different between the two groups. Conclusion: Regional epidural anesthesia is an alternative technique for PCNL which achieves more patient satisfaction, less early postoperative pain and less adverse effects from medication with the same efficacy and safety compared to general anesthesia
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