OUR EXPERIENCE OF REGIONAL ANESTHESIA FOR PERCUTAEOUS NEPHROLITHOTOMY SURGERIES IN 213 CASES

Abstract

Percutaneous nephrolithotomy (PCNL) is mainly done for renal and upper ureteral stone removal1. Anesthesia techniques are general or regional anesthesia. Many studies have shown perioperative events related to anaesthesia 2. Regional anesthesia is preferred mainly to avoid general anesthesia related complications, and postoperative morbidity and to enhance practice of fasttracking. So we studied intraoperative instability, postoperative complications and patient and surgeon satisfaction in patients who received regional anaesthesia. After ethical committee approval, regional Method: anaesthesia were given for all 213 patients between 18-65 yrs who underwent PCNL surgeries. Perioperative hemodynamics like blood pressure, heart rate , postoperative complications in terms of shivering, vomiting, blood loss, pain and patients's and urosurgeon's satisfaction score was assessed. Out of 213, 28 patients were Result: received combined spinal epidural anaesthesia. Spinal anaesthesia was given to remaining 185 patients. In Intraoperative events, bradycardia (1), hypotension ( 31), bleeding at surgical site(2), and 1 case with hemothorax. Pain score was tolerable in 183 (85.9%) and intolerable in 30 (14%) patients. Hospital stay was total 3 days in 79% cases, more than 3 days in 21% cases. Surgeon's Satisfaction score was 2 in 23.9%, 3 in 75% for surgeons. Patient s satisfaction score was 2 in 24% and 3 in 75 %. In this mi Conclusion: nimally invasive urosurgeries, regional anaesthesia is an altenative anaesthesia choice for PCNL because of better hemodynamic stability, lesser complications and better satisfaction by surgeons and patients. Counselling, optimization of the patients by anaesthesiologists ,urosurgeons are needed for rapid recovery of such cases