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. 2013 Dec 26;4(1):e13871.
doi: 10.5812/aapm.13871. eCollection 2014 Feb.

Comparison between spinal and general anesthesia in percutaneous nephrolithotomy

Gholamreza Movasseghi  1 , Valiollah Hassani  2 , Mahmood Reza Mohaghegh  1 , Reza Safaeian  3 , Saeid Safari  3 , Mohammad Mahdi Zamani  3 , Roya Nabizadeh  3
Affiliations

Comparison between spinal and general anesthesia in percutaneous nephrolithotomy

Gholamreza Movasseghi et al. Anesth Pain Med. .

Abstract

Background: Hemodynamic stability and blood loss reduction are subjects to further consideration in patients undergoing percutaneous nephrolithotomy (PNCL).

Objectives: This study compared the preference of spinal anaesthesia (SA) or general anaesthesia (GA) in respect to mentioned concerns.

Patients and methods: In this randomized clinical trial, 59 patients who underwent PCNL divided into SA and GA groups. 15-20 mg from intra-thecal bupivacaine 0.5%, and premedication of 0.01-0.02 mg from midazolam, were given to patients in SA group (n = 29). Patients in GA group (n = 30) received premedication of 1-2 µg/kg from fentanyl and 0.01-0.02 mg/kg from midazolam, and intravenously anaesthetized with 100 µg/kg/min of propofol and 0.5 mg/kg of atracurium, given by continuous infusion and N2O/O2 50%. Mean arterial pressure (MAP) and heart rate were recorded intra-operatively and during recovery.

Results: MAP and heart rate show no significant differences at designated time points between two groups (P > 0.05). Surgery time, anesthesia time, bleeding volume, and analgesic intake were significantly reduced in SA group (P < 0.05).

Conclusions: It seems that, in patients undergoing PNCL, SA is as effective and safe as GA. Patients who undergo PNCL under SA require smaller amounts of analgesic dose and show hemodynamic stability during surgery and recovery time. Also, SA technique provides decreased blood loss and shortened surgery as well as anesthesia times compared to GA.

Keywords: Analgesia; Hemodynamics; Hemorrhage; Nephrostomy, Percutaneous.

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Figures

Figure 1.
Figure 1.. Trends of Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP), and Pulse Rate (PR) in Operation Room. None of the factors differed significantly (P = 0.990, P = 0.568, P = 0.710, P = 0.934, respectively- from Repeated measurements)
Figure 2.
Figure 2.. Trends of Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP), and Pulse Rate (PR) in Recovery Room. None of the factors differed significantly (P = 0.844, P = 0.122, P = 0.863, P = 0.855, respectively- from Repeated measurements)
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