Efficacy and Safety of Percutaneous Nephrolithotomy under Spinal Anesthesia

Abstract

Hayder Mahdi Alaridy

The patients harboring Staghorn calculi, large kidney calculi, multiple calculi, or calculi resistant to shock wave lithotripsy are generally treated using percutaneous Nephrolithotomy (PCNL), with the standard modality being general anesthesia. This study is aimed to assess the efficacy of PCNL under spinal anesthesia (SA). Data were collected from 418 patients who underwent PCNL under SA, including the surgery parameters, demographic data, postoperative findings, and urinary system and stone characteristics. Among the enrolled 418 patients, 184 patients were female and 234 were male, with a mean age of 44.35±14.05 years. Mean stone load was 34.44±15.10 mm, with an average duration of surgery of 65.70±18.98 min and the mean hospitalization period of 42.29±11.70 h. The overall success rate was 87.32%. During the first 10 min after induction, 42 (10.04% patients exhibited hypotension that was managed by intravenous administration of ephedrine. Twenty patients (4.78%) needed blood transfusion, and 22 patients (5.26%) complained of dizziness, lower back pain, and headache that were managed with bed rest and analgesics. Nineteen patients (4.54%) suffered from postoperative fever. There were no major complications. Under SA, adult patients can be safely treated with PCNL with low complication and high success rate.