Limitations of Spinal Anesthesia for Patient and Surgeon During Percutaneous Nephrolithotomy
Urology Journal,
Vol. 15 No. 4 (2018),
10 July 2018
,
Page 164-167
https://doi.org/10.22037/uj.v15i4.3993
Abstract
Purpose: To evaluate the intraoperative pain score of patients who undergo percutaneous nephrolithotomy under spinal anesthesia and to evaluate surgeons' and patients' convenience with this type of anesthesia.Materials and Methods: PCNL cases who were performed by two endourology fellows under spinal anesthesia during June to July 2014 were included. Spinal anesthesia was performed using injection of 0.25mg/kg bupivacaine 0.5% in the intrathecal space. All procedures were performed with the patient in the prone position. Stone access was made by using ?uoroscopic guidance, and the tract was dilated using a single-stage technique. Visual analogue pain score was used to assess patients' pain during operation, immediately after, and 2 hours later.
Results: 50 patients were enrolled during the study period. Visual analogue pain score of 10 and 8 were observed in 5 and three patients respectively. In two patients the operation was terminated because of patient anxiety and pain. In another patient a second access was not obtained to remove a staghorn stone because of patient's agitation. Gross agitation was observed in six patients. Apart from flank pain, intraoperative pain was felt in the flank, scapula, abdomen and/or chest.
Conclusion: Spinal anesthesia does not provide enough analgesia for the patient in a limited frequency of percutaneous nephrolithotomy operations. We could not find statistically significant predictors of insufficient analgesia
based on patients' demographics, stone characteristics or access location.
How to Cite
Basiri, A., Kashi, A. H., Zeinali, M., Nasiri, M. R., Valipour, R., & Sarhangnejad, R. (2018). Limitations of Spinal Anesthesia for Patient and Surgeon During Percutaneous Nephrolithotomy. Urology Journal, 15(4), 164–167. https://doi.org/10.22037/uj.v15i4.3993
References
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World J Urol. 2010;28:239-44.
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3. Cicek T, Gonulalan U, Dogan R, et al. Spinal anesthesia is an efficient and safe anesthetic method for percutaneous nephrolithotomy. Urology. 2014;83:50-5.
4. 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.
5. Kuzgunbay B, Turunc T, Akin S, Ergenoglu P, Aribogan A, Ozkardes H. Percutaneous nephrolithotomy under general versus combined spinal-epidural anesthesia. J Endourol. 2009;23:1835-8.
6. Movasseghi G, Hassani V, Mohaghegh MR, et al. Comparison between spinal and general anesthesia in percutaneous nephrolithotomy. Anesth Pain Med. 2014;4:e13871.
7. Saied MM, Sonbul ZM, el-Kenawy M, Atallah MM. Spinal and interpleural bupivacaine for percutaneous nephrolithotomy. Middle East J Anesthesiol. 1991;11:259-64.
8. 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;87:293-8.
9. Andreoni C, Olweny EO, Portis AJ, Sundaram CP, Monk T, Clayman RV. Effect of singledose subarachnoid spinal anesthesia on pain and recovery after unilateral percutaneous nephrolithotomy. J Endourol. 2002;16:721-5.
10. Gonen M, Basaran B. Tubeless percutaneous nephrolithotomy: spinal versus general anesthesia. Urol J. 2014;11:1211-5.
11. Mehrabi S, Mousavi Zadeh A, Akbartabar Toori M, Mehrabi F. General versus spinal anesthesia in percutaneous nephrolithotomy. Urol J. 2013;10:756-61.
12. Singh I, Kumar A, Kumar P. "Ambulatory PCNL" (tubeless PCNL under regional anesthesia) -- a preliminary report of 10 cases. Int Urol Nephrol. 2005;37:35-7.
13. Radfar MH, Basiri A, Nouralizadeh A, et al. Comparing the Efficacy and Safety of Ultrasonic Versus Pneumatic Lithotripsy in Percutaneous Nephrolithotomy: A Randomized Clinical Trial. Eur Urol Focus.
2017;3:82-8.
14. Sichani MM, Kashi AH, Al-Mousawi S, Tabibi A. An assessment of serum sodium within 48 h after percutaneous nephrolithotomy with half-strength saline solution. Urol Res. 2010;38:413-6.
15. Mehrabi S, Karimzadeh Shirazi K. Results and complications of spinal anesthesia in percutaneous nephrolithotomy. Urol J. 2010;7:22-5.
World J Urol. 2010;28:239-44.
2. Nouralizadeh A, Ziaee SA, Hosseini Sharifi SH, et al. Comparison of percutaneous nephrolithotomy under spinal versus general anesthesia: a randomized clinical trial. J Endourol. 2013;27:974-8.
3. Cicek T, Gonulalan U, Dogan R, et al. Spinal anesthesia is an efficient and safe anesthetic method for percutaneous nephrolithotomy. Urology. 2014;83:50-5.
4. 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.
5. Kuzgunbay B, Turunc T, Akin S, Ergenoglu P, Aribogan A, Ozkardes H. Percutaneous nephrolithotomy under general versus combined spinal-epidural anesthesia. J Endourol. 2009;23:1835-8.
6. Movasseghi G, Hassani V, Mohaghegh MR, et al. Comparison between spinal and general anesthesia in percutaneous nephrolithotomy. Anesth Pain Med. 2014;4:e13871.
7. Saied MM, Sonbul ZM, el-Kenawy M, Atallah MM. Spinal and interpleural bupivacaine for percutaneous nephrolithotomy. Middle East J Anesthesiol. 1991;11:259-64.
8. 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;87:293-8.
9. Andreoni C, Olweny EO, Portis AJ, Sundaram CP, Monk T, Clayman RV. Effect of singledose subarachnoid spinal anesthesia on pain and recovery after unilateral percutaneous nephrolithotomy. J Endourol. 2002;16:721-5.
10. Gonen M, Basaran B. Tubeless percutaneous nephrolithotomy: spinal versus general anesthesia. Urol J. 2014;11:1211-5.
11. Mehrabi S, Mousavi Zadeh A, Akbartabar Toori M, Mehrabi F. General versus spinal anesthesia in percutaneous nephrolithotomy. Urol J. 2013;10:756-61.
12. Singh I, Kumar A, Kumar P. "Ambulatory PCNL" (tubeless PCNL under regional anesthesia) -- a preliminary report of 10 cases. Int Urol Nephrol. 2005;37:35-7.
13. Radfar MH, Basiri A, Nouralizadeh A, et al. Comparing the Efficacy and Safety of Ultrasonic Versus Pneumatic Lithotripsy in Percutaneous Nephrolithotomy: A Randomized Clinical Trial. Eur Urol Focus.
2017;3:82-8.
14. Sichani MM, Kashi AH, Al-Mousawi S, Tabibi A. An assessment of serum sodium within 48 h after percutaneous nephrolithotomy with half-strength saline solution. Urol Res. 2010;38:413-6.
15. Mehrabi S, Karimzadeh Shirazi K. Results and complications of spinal anesthesia in percutaneous nephrolithotomy. Urol J. 2010;7:22-5.
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