Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul-Sep;15(3):306-311.
doi: 10.4103/aer.aer_124_21. Epub 2022 Feb 14.

A Comparative Study of Epidural Anesthesia with Dexmedetomidine Infusion versus General Anesthesia for Percutaneous Nephrolithotomy

Sonali Turki  1 , Shafat Ahmad Mir  1 , Khalid P Sofi  1 , Nadeem Khan  1 , Rouf Khawaja  2 , Mohammad S Wani  2
Affiliations

A Comparative Study of Epidural Anesthesia with Dexmedetomidine Infusion versus General Anesthesia for Percutaneous Nephrolithotomy

Sonali Turki et al. Anesth Essays Res. 2021 Jul-Sep.

Abstract

Background: There has been considerable debate regarding the ideal anaesthetic technique for Percutaneous Nephrolithotomy (PCNL). PCNL is usually performed under general anaesthesia (GA) in prone position. The prone position under GA is associated with various complications. To address these complications, our study was carried out to determine whether epidural anaesthesia [EA] with dexmedetomidine sedation can be a better alternative to GA for PCNL.

Aims and objectives: To compare the efficacy and feasibility of performing PCNL under EA in combination with dexmedetomidine infusion.

Methods and material: Out of 225 patients observed in this study, 115 patients (group A) underwent PCNL under EA with dexmedetomidine infusion and 110 patients (group B) underwent PCNL under GA.

Results: Mean time to the first dose of rescue analgesia was significantly increased in Epidural group (328.17 ± 63.74) compared to GA group (72.09 min, p < .0001) and the mean Visual analog scale [VAS] scores were significantly lower in epidural compared to GA group at different time intervals during the first 24 h after surgery (p<0.05). Patients in epidural group had significantly less post-operative nausea, vomiting (6.1 % vs 13.6 %), and significantly less shivering (12.2% vs 33.6%). Mean patient satisfaction score in epidural group was significantly higher (8.75 ± 1.29 vs 8.14 ± 1.39, p=0.001); however, the mean surgeon satisfaction score was comparable among the two groups (8.76 ± 1.39 in Group A and 8.61 ± 1.35 in Group B, p=0.421).

Conclusions: Our study shows that EA is an equally effective alternative to GA for PCNL, with more patient satisfaction, less postoperative pain, early ambulation and postoperative recovery, less systemic analgesic requirements and less adverse effects.

Keywords: General anaesthesia; epidural anaesthesia; percutaneous nephrolithotomy.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Mean heart rate at various time intervals
Figure 2
Figure 2
Comparison of mean arterial pressure between Group A and Group B. Group A. Epidural Anesthesia. Group B. General Anesthesia
Figure 3
Figure 3
Comparison of Visual Analog Scale score between Group A and Group B. Group A. Epidural Anesthesia. Group B. General Anesthesia
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Knoll T, Schubert AB, Fahlenkamp D, Leusmann DB, Wendt-Nordahl G, Schubert G. Urolithiasis through the ages: Data on more than 200,000 urinary stone analyses. J Urol. 2011;185:1304–11. - PubMed
    1. Fernström I, Johansson B. Percutaneous pyelolithotomy.A new extraction technique. Scand J Urol Nephrol. 1976;10:257–9. - PubMed
    1. Ramakumar S, Segura JW. Renal calculi.Percutaneous management. Urol Clin North Am. 2000;27:617–22. - PubMed
    1. Goh M, Wolf JS., Jr Almost totally tubeless percutaneous nephrolithotomy: Further evolution of the technique. J Endourol. 1999;13:177–80. - PubMed
    1. Saied MM, Sonbul ZM, el-Kenawy M, Atallah MM. Spinal and interpleural bupivacaine for percutaneous nephrolithotomy. Middle East J Anaesthesiol. 1991;11:259–64. - PubMed