Abstract

BackgroundWe analyzed the influence of anesthesia methods on surgical outcomes and renal function in retrograde intrarenal surgery (RIRS) in a prospective, randomized controlled study.MethodsSeventy patients who underwent RIRS from September 2015 to February 2017 were randomly allocated to general anesthesia (GA) or spinal anesthesia (SA) groups. Renal function was assessed using estimated glomerular filtration rate, and separate renal function was evaluated using nuclear medicine tests. Maneuverability and accessibility were evaluated after every surgery. All procedures were performed by a single experienced surgeon (SY Cho).ResultsStone-free rate was higher in the GA (92.3%, 36 of 39) than the SA (71.0%, 22 of 31) (P = 0.019) group. Pain score was higher in the GA than in the SA group on the first postoperative morning (P = 0.025), but pain scores of the two groups were similar before discharge (P = 0.560). There were no differences in the changes of serum creatinine level (P = 0.792) and changes of estimated glomerular filtration rate (P = 0.807). Differences of separate renal function between operative and contralateral site increased significantly in patients under GA than under SA at postoperative 3 months (P = 0.014). Maneuverability and accessibility were better in SA with sedation than GA (P < 0.001).ConclusionsRIRS under SA showed advantages in renal function change using renogram at postoperative 3 months and in lower pain score on the first postoperative morning. Performance of operator under SA was worse than that under GA and significantly improved with sedation. RIRS under SA showed advantages in lower pain score at postoperative first day.Trial registrationClinicaltrials.gov ID is NCT03957109, and registration date is 17th May 2019. This study was retrospectively registered.

Highlights

  • We analyzed the influence of anesthesia methods on surgical outcomes and renal function in retrograde intrarenal surgery (RIRS) in a prospective, randomized controlled study

  • Thirty-nine patients were assigned to the general anesthesia (GA) group, and 31 patients were assigned to the spinal anesthesia (SA) group

  • The blockade level of spinal anesthesia was between T2-T10

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Summary

Introduction

We analyzed the influence of anesthesia methods on surgical outcomes and renal function in retrograde intrarenal surgery (RIRS) in a prospective, randomized controlled study. Renal function abnormalities or perioperative renal dysfunction due to anesthesia, may be present even in normal patients. A previous study reported that renal dysfunction could happen even in patients who had normal renal function preoperatively [11]. These complications are associated with the type of surgery, baseline renal function, underlying diseases, and the amount of intraoperative bleeding. There are few previous studies comparing anesthetic methods with respect to renal function [13,14,15]

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