Abstract

Objective: Today, many surgical procedures can be performed under spinal anesthesia instead of general anesthesia. In this study, we compared the outcome of tubeless percutaneous nephrolithotomy performed under spinal anesthesia and general anesthesia.

Materials and methods: Between December 2008 and March 2009, 21 patients with renal calculi were treated with tubeless percutaneous nephrolithotomy under spinal anesthesia. Patients at pediatric age group, cooperation difficulty during operation, and possibility of operation time over 2 hours were not given spinal anesthesia. The only exclusion criteria for tubeless percutaneous nephrolithotomy was clinically significant residuel fragments. The results of these patients and the results of 62 patients who underwent tubeless percutaneous nephrolithotomy under general anesthesia between January 2008 and August 2008 were matched for stone burden and age, and were compared. Two groups were identified regarding to anesthesia technique: spinal anesthesia (Group 1, n=21) and general anesthesia (Group 2, n=21). The groups were compared in terms of operation duration, postoperative hospital stay, analgesic requirement, hemoglobin drop, and stone-free rate.

Results: Preoperative data and patient demographics were comparable between groups. There was no diffeence between groups in terms of stone-free rate, hospital stay, hemoglobin drop, and operation duration. However, the analgesic requirement was significantly higher in general anesthesia group than spinal anesthesia group (30.9 mg vs. 59.5 mg tramadol HCl, p=0.009).

Conclusion: Tubeless percutaneous nephrolithotomy under spinal anesthesia is a feasible operation. Moreover, it has the advantage of less analgesic requirement postoperatively.