| Peer-Reviewed

Comparison of Surgical Outcome and Complications Between Spinal and General Anaesthesia for Patients Undergoing Percutaneous Nephrolithotomy

Received: 18 February 2015     Accepted: 10 March 2015     Published: 19 March 2015
Views:       Downloads:
Abstract

Background: Percutaneous nephrolithotomy (PCNL) now a days is the treatment of choice for most renal stones, staghorn calculi and stones resistant to shock wave lithotripsy. Mostly PCNL is done under general anesthesia. However, it can be done under spinal anaesthesia which can have advantages like easier technique, faster discharge, reduced cost and recovery time and most important patient satisfaction. Aim: Unfortunately, few research studies have been conducted to compare regional and general anesthesia with respect to operative parameters. In the present study, we compared surgical outcomes and complications between percutaneous nephrolithotomy under spinal and general anesthesia. Materials and Method: 60 patients were divided into two groups of 30 each (GA/SA), who were undergone percutaneous nephrolithotomy under spinal and general anaesthesia. Patient’s general characteristics, stone features, surgical outcomes, and complications were compared between the two groups. All qualitative data and quantitative data were analyzed by chi square and student’s t test respectively. P value <0.05 was considered statistically significant. Result: The two groups were similar in terms of mean age and stone size, number, and type. Furthermore, they did not differ significantly in terms of general characteristics, treatment outcomes or complications excluding postoperative fever. However, mean hospital stay was significantly shorter in the regional anesthesia group than in the general anesthesia group (8.2±1.6 days vs. 12.5±2.8) days, respectively, (p=0.0001), Also, the postoperative fever rate was significantly higher in the general anesthesia group (82.5% vs 50%) respectively. (p=0.012). The treatment cost was 30$ in GA group and 10 $ in spinal group which was statistically significant. Also analgesia requirement on day 1 was more in GA group than SA group which was statistically significant. Conclusion: Regional anaesthesia is as effective as general anaesthlesia during percutaneous nephrolithotomy and is associated with shorter hospital stays, lower rates of postoperative fever, lower analgesic requirement and treatment cost.

Published in Journal of Anesthesiology (Volume 3, Issue 1)
DOI 10.11648/j.ja.20150301.11
Page(s) 1-5
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Anaesthesia, Complications, Percutaneous Nephrolithotomy

References
[1] Tiselius HG, Alken P, Buck J. Guideline on urolithiasis. Eur Urol. 2001;40:362-71
[2] El-Husseiny T, Moraitis K, Maan Z. Percutaneous endourologic procedures in high- risk patients in the lateral decubitus position under regional anesthesia. J Endourol. 2009;23:1603-6
[3] Barak M, Putilov V, Meretyk S, Halachmi S. ET View tracheoscopic ventilation tube for surveillance after tube position in patients undergoing percutaneous nephrolithotomy. Br J Anaesthe. 2010; 104:501-504.
[4] Salonia A, Suardi N, Crescenti A, Colombo R, Rigatti P, Montorsi F. General versus spinal anesthesia with different forms of sedation in patients undergoing radiacal retropubic prostatectomy: results of a prospective, randomized study. Int J Urol. 2006; 13:1185-1190.
[5] Maurer SG, Chen AL, Hiebert R, Pereia GC, Di Cesare PE. Comparison of outcomes of suing spinal versus general anesthesia in total hip arthroplasty. Am J orthop. 2007; 36:E101-E106.
[6] V. rozentsveig, EZ. Neulander, E. Roussabrov, Anesthetic considerations during percutaneous nephrolithotomy. J Clin anesth, 2007 Aug ; 19:351-355,
[7] V. Ballestrazzi, C. Zboralski, P. Smith –Morel, M. Boullet, I. Willot, D. Hochart, P. Scherpereel, Importance of suspended peridural anesthesia in percutaneous nephrolithotomy. Anesthesiol. 1998 Mar-Apr ; 36:85-88,.
[8] Sung Soo Kim, Jeong Woo Lee, Ji Hyoung Yu, Luck Hee Sung. Jae Yong Chung, and Choong Hee Noh. Percutaneous nephrolithotomy: Comparison of the Efficacies and Feasibilities of Regional and General Anesthesia. Korean J Urol. 2013 Dec; 54 (12):846-850.
[9] Tangpaitoon T, Nisoog C, Lojanapiwat B. Efficacy and safety of percutaneous nephrolithotomy (PCNL): a prospective and randomized study comparing regional epidural anesthesia with general anesthesia. Int Braz J urol. 2012;38:504-511.
[10] Gholamreza Movasseghi , Valiollah Hassani , Mahmood Reza Mohabgegh. comparison between Spinal and General Anesthesia in Percutaneous Nephrolithotomy. anesth Pain Med, 2013 Dec; 3(3):e13871.
[11] Babak Borzouei, Seyed Habibollah Mousavi-Bahar. Results of Percutaneous Nephrolithotomy under Spinal Anesthesia World Academy of Science, Engineering and Technology. 2012;6:05-20.
[12] Mehrabi S, Karimzadeh Shirazi K. Results and complication of spinal anesthesia in percutaneous nephrolithotomy. Urol J. 2010;7:22-5.
[13] Mehrabi S, Mousavi Zadeh A, Akbartabar Toori M, Mehrabi F. General versus spinal anesthesia in percutaneous nephrolithotomy. Urol J. 2013;10:756-761.
[14] Schuster M, Gottschalk A, Berger J, Standl T. A retrospective comparision of costs for regional and general anesthesia techniques. Anesth analg. 2005;100:786-94.
[15] Nouralizadeh A1, Ziaee SA, Hosseini Sharifi SH, Basiri A, Tabibi A, Sharifiaghdas F, Kilani H, Gharaei B, Roodneshin F, Soltani MH Comparison of percutaneous nephrolithotomy under spinal versus general anesthesia: a randomized clinical trial. J Endourol. 2013 Aug; 27(8):974-8.
[16] Gonen M, Basaran B. Tubeless percutaneous nephrolithotomy: spinal versus general anesthesia. Urol J. 2014 Mar 3;11(1):1211-5.
[17] Kuzgunbay B, Turunc T, Asin S, Ergenoglu P, Aribogan A, Ozkardes H. percutaneous nephrolithotomy under general versus combined spinal-epidural anaesthesia. J Endourol. 2009; 23: 1835-8.
[18] Singh V, Sinha Rj, Sankhwar SN, Malik A.A prospective randomized study comparing percutaneous nephrolithotomy under combined spinal-epidural anesthesia with percutaneous nephrolithotomy under general anesthesia. Urol Int. 2011; 87(3):293-8.
[19] Singh I, Kumar A, Kumar P.Ambulatory PCNL” tubeless PCNL under regional anaesthesia a preliminary report of 10 cases. Int urol Nephrol. 2005;37 (1):35-7.
[20] Karacalar S, Bilen CY, Sarihasan B, Sarikaya S: Spinal-epidural anesthesia versus general anesthesia in the management of percutaneous nephrolithotripsy. J Endourol. 2009; 23: 1591-7.
[21] Andreoni C, Olwenty EO, Portis AJ, Sundaram CP, Monk T, Clayman RV. Effect of single dose subarachnoid spinal anesthesia on pain and recovery after unilateral percutaneous nephrolithotomy. J Endoural. 2002 Dec; 16(10):721-5.
[22] Atallah MM, Shorrab AA, Abdel Mageed YM, Demian AD. Low-dose bupivacaine spinal anesthesia for percutaneous nephrolithotomy: the suitability and impact of adding intrathecal fentanyl. Acta Anaesthesiaol Scand. 2006 Aug; 50(7):798-803.
[23] G Sunana, G Rahul, M Nandita, M Arti, V Siddarth, M Rajesh. Per Cutaneous Nephrolithotomy Under Spinal Anesthesia and The Efficacy of Adding Adjuvant Clonidine To Interthecal Hyperbaric Bupivacaine: A comparative study. The Internet Journal of anesthesiology. 2014; 33(1).
Cite This Article
  • APA Style

    Sidharth Sraban Routray, Debadas Biswal, Khagaswar Raut, Kamalakanta Pradhan, Debasis Mishra, et al. (2015). Comparison of Surgical Outcome and Complications Between Spinal and General Anaesthesia for Patients Undergoing Percutaneous Nephrolithotomy. International Journal of Anesthesia and Clinical Medicine, 3(1), 1-5. https://doi.org/10.11648/j.ja.20150301.11

    Copy | Download

    ACS Style

    Sidharth Sraban Routray; Debadas Biswal; Khagaswar Raut; Kamalakanta Pradhan; Debasis Mishra, et al. Comparison of Surgical Outcome and Complications Between Spinal and General Anaesthesia for Patients Undergoing Percutaneous Nephrolithotomy. Int. J. Anesth. Clin. Med. 2015, 3(1), 1-5. doi: 10.11648/j.ja.20150301.11

    Copy | Download

    AMA Style

    Sidharth Sraban Routray, Debadas Biswal, Khagaswar Raut, Kamalakanta Pradhan, Debasis Mishra, et al. Comparison of Surgical Outcome and Complications Between Spinal and General Anaesthesia for Patients Undergoing Percutaneous Nephrolithotomy. Int J Anesth Clin Med. 2015;3(1):1-5. doi: 10.11648/j.ja.20150301.11

    Copy | Download

  • @article{10.11648/j.ja.20150301.11,
      author = {Sidharth Sraban Routray and Debadas Biswal and Khagaswar Raut and Kamalakanta Pradhan and Debasis Mishra and Jagannath Mishra},
      title = {Comparison of Surgical Outcome and Complications Between Spinal and General Anaesthesia for Patients Undergoing Percutaneous Nephrolithotomy},
      journal = {International Journal of Anesthesia and Clinical Medicine},
      volume = {3},
      number = {1},
      pages = {1-5},
      doi = {10.11648/j.ja.20150301.11},
      url = {https://doi.org/10.11648/j.ja.20150301.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20150301.11},
      abstract = {Background: Percutaneous nephrolithotomy (PCNL) now a days is the treatment of choice for most renal stones, staghorn calculi and stones resistant to shock wave lithotripsy. Mostly PCNL is done under general anesthesia. However, it can be done under spinal anaesthesia which can have advantages like easier technique, faster discharge, reduced cost and recovery time and most important patient satisfaction. Aim: Unfortunately, few research studies have been conducted to compare regional and general anesthesia with respect to operative parameters. In the present study, we compared surgical outcomes and complications between percutaneous nephrolithotomy under spinal and general anesthesia. Materials and Method: 60 patients were divided into two groups of 30 each (GA/SA), who were undergone percutaneous nephrolithotomy under spinal and general anaesthesia. Patient’s general characteristics, stone features, surgical outcomes, and complications were compared between the two groups. All qualitative data and quantitative data were analyzed by chi square and student’s t test respectively. P value <0.05 was considered statistically significant. Result: The two groups were similar in terms of mean age and stone size, number, and type. Furthermore, they did not differ significantly in terms of general characteristics, treatment outcomes or complications excluding postoperative fever. However, mean hospital stay was significantly shorter in the regional anesthesia group than in the general anesthesia group (8.2±1.6 days vs. 12.5±2.8) days, respectively, (p=0.0001), Also, the postoperative fever rate was significantly higher in the general anesthesia group (82.5% vs 50%) respectively. (p=0.012). The treatment cost was 30$ in GA group and 10 $ in spinal group which was statistically significant. Also analgesia requirement on day 1 was more in GA group than SA group which was statistically significant. Conclusion: Regional anaesthesia is as effective as general anaesthlesia during percutaneous nephrolithotomy and is associated with shorter hospital stays, lower rates of postoperative fever, lower analgesic requirement and treatment cost.},
     year = {2015}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Comparison of Surgical Outcome and Complications Between Spinal and General Anaesthesia for Patients Undergoing Percutaneous Nephrolithotomy
    AU  - Sidharth Sraban Routray
    AU  - Debadas Biswal
    AU  - Khagaswar Raut
    AU  - Kamalakanta Pradhan
    AU  - Debasis Mishra
    AU  - Jagannath Mishra
    Y1  - 2015/03/19
    PY  - 2015
    N1  - https://doi.org/10.11648/j.ja.20150301.11
    DO  - 10.11648/j.ja.20150301.11
    T2  - International Journal of Anesthesia and Clinical Medicine
    JF  - International Journal of Anesthesia and Clinical Medicine
    JO  - International Journal of Anesthesia and Clinical Medicine
    SP  - 1
    EP  - 5
    PB  - Science Publishing Group
    SN  - 2997-2698
    UR  - https://doi.org/10.11648/j.ja.20150301.11
    AB  - Background: Percutaneous nephrolithotomy (PCNL) now a days is the treatment of choice for most renal stones, staghorn calculi and stones resistant to shock wave lithotripsy. Mostly PCNL is done under general anesthesia. However, it can be done under spinal anaesthesia which can have advantages like easier technique, faster discharge, reduced cost and recovery time and most important patient satisfaction. Aim: Unfortunately, few research studies have been conducted to compare regional and general anesthesia with respect to operative parameters. In the present study, we compared surgical outcomes and complications between percutaneous nephrolithotomy under spinal and general anesthesia. Materials and Method: 60 patients were divided into two groups of 30 each (GA/SA), who were undergone percutaneous nephrolithotomy under spinal and general anaesthesia. Patient’s general characteristics, stone features, surgical outcomes, and complications were compared between the two groups. All qualitative data and quantitative data were analyzed by chi square and student’s t test respectively. P value <0.05 was considered statistically significant. Result: The two groups were similar in terms of mean age and stone size, number, and type. Furthermore, they did not differ significantly in terms of general characteristics, treatment outcomes or complications excluding postoperative fever. However, mean hospital stay was significantly shorter in the regional anesthesia group than in the general anesthesia group (8.2±1.6 days vs. 12.5±2.8) days, respectively, (p=0.0001), Also, the postoperative fever rate was significantly higher in the general anesthesia group (82.5% vs 50%) respectively. (p=0.012). The treatment cost was 30$ in GA group and 10 $ in spinal group which was statistically significant. Also analgesia requirement on day 1 was more in GA group than SA group which was statistically significant. Conclusion: Regional anaesthesia is as effective as general anaesthlesia during percutaneous nephrolithotomy and is associated with shorter hospital stays, lower rates of postoperative fever, lower analgesic requirement and treatment cost.
    VL  - 3
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Department of Anaesthesiology and critical care, SCB Medical College, Hospital, Cuttack, Odisha, India

  • Department of Anaesthesiology and critical care, SCB Medical College, Hospital, Cuttack, Odisha, India

  • Department of Anaesthesiology and critical care, SCB Medical College, Hospital, Cuttack, Odisha, India

  • Department of Anaesthesiology and critical care, SCB Medical College, Hospital, Cuttack, Odisha, India

  • Department of Anaesthesiology and critical care, SCB Medical College, Hospital, Cuttack, Odisha, India

  • Department of Anaesthesiology and critical care, SCB Medical College, Hospital, Cuttack, Odisha, India

  • Sections