Abstract
ABSTRACTPurpose To compare the effect of general anesthesia (GA) and regional anesthesia (RA) on f-URS 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 f-URS procedures. However, RA group showed significantly increased likelihood of bradycardia and mucosal injury during surgery, and significantly decreased surgeon comfort during surgery.
Highlights
Urolithiasis is a widespread disorder all around the worldwide and almost 10% of the population faces urolithiasis related health problems during their life-span [1]
The study included 120 randomized patients, 14 patients were excluded from the study and completed with 106 patients (45 in regional anesthesia (RA) group and 61 in general anesthesia (GA) group)
Three patients in RA group and two patients in GA group were converted to mini-percutaneous nephrolithotomy (PNL) procedure because of the failure of ureteral access sheath placement due to ureteral stricture
Summary
Urolithiasis is a widespread disorder all around the worldwide and almost 10% of the population faces urolithiasis related health problems during their life-span [1]. Flexible ureterorenoscopy (f-URS) is the state of art, and accepted as an important approach in the management of renal stones because of its reasonable success and lower complication rates [2, 3]. There has been an extensive examination of factors affecting f-URS success, such as stone volume, stone location, stone number and surgeon experience, ; effect of anesthesia type has not been evaluated sufficiently [4, 5]. Many studies have investigated the possible predictive factors which may have an effect on f-URS outcomes, the role of anesthesia type has not been evaluated sufficiently. The present study was the first to compare the effect of general anesthesia (GA) and regional anesthesia (RA) on f-URS outcomes and surgeon comfort
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