Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
A Prospective Randomized Study Comparing Retrograde Intrarenal Surgery Under Spinal Anaesthesia Versus General Anaesthesia
Retrograd İntrarenal Cerrahide Genel Anestezi ve Spinal Anestezi Karşılaştırması: Prospektif Randomize Bir Çalışma
Eyyup Sabri PELİTa, Orhan BİNİCİb, Bülent KATIa, İsmail YAĞMURa, Mehmet DEMİRa, Erkan ARSLANa, Adem TUNÇEKİNa, Halil ÇİFTÇİa
aHarran University Faculty of Medicine, Department of Urology, Şanlıurfa, TURKEY
bHarran University Faculty of Medicine, Department of Anesthesiology and Reanimation, Şanlıurfa, TURKEY
J Reconstr Urol. 2020;10(1):28-34
doi: 10.5336/urology.2020-75691
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of this study is to compare the intraoperative parameters, postoperative pain, surgical parameters, complication rates, and stone-free rates in patients who underwent retrograde intrarenal surgery (RIRS) under spinal anaesthesia (SA) versus general anaesthesia (GA). Material and Methods: A total of 100 patients treated with RIRS under SA (50) and GA (50) for renal stones were compared prospectively. The operative and postoperative outcomes of both groups were then analysed prospectively. Results: The demographic data was comparable between the two groups in terms of patient age, gender, and American Society of Anaesthesiologist (ASA) score as well as the size, lateralization, and location of the stones. And also, the mean operative times, fluoroscopy times, hospitalization times, and stone free rates were similar between the two groups. Postoperative Visual Analogue Scale (VAS) scores-measured only two hours after surgery-and rescue analgesia need were found statistically significantly lower in the SA group when compared with the GA group. Minor complication (Clavien 1-3) rates were 18% and 12% for the SA and GA group, respectively (p > 0.05). Conclusion: RIRS with SA can be performed safely and effectively to manage kidney stones, producing the same stone free rate (SFR) and complication rates when compared to GA.

Keywords: Anesthesia, spinal; kidney calculi; ureteroscopy
ÖZET
 Amaç: Bu çalışmada, spinal anestezi (SA) ve genel anestezi (GA) altında RIRS uygulanan hastalarda intraoperatif parametreleri, postoperatif ağrı skorlarını, cerrahi parametreleri, komplikasyon oranlarını ve taşsızlık oranlarını karşılaştırmak amaçlanmıştır. Gereç ve Yöntemler: Böbrek taşı olan toplam 100 hasta SA (50) ve GA (50) altında RIRS uygulandı ve her iki grup prospektif olarak karşılaştırıldı. Her iki grubun per-operatif ve postoperatif sonuçları prospektif olarak analiz edildi. Bulgular: Her iki grup demografik veriler açısından karşılaştırıldığında yaş, cinsiyet, boyut, taraf, taş yerleşimi ve hastaların ASA skorları açısından benzerdi. Ayrıca ortalama ameliyat süreleri, floroskopi süreleri, hastanede yatış süreleri ve taşsızlık oranları iki grup arasında benzerdi. Post op 2. saatteki VAS skorları ve kurtarma analjezi gereksinimi SA grubunda GA grubuna göre istatistiksel olarak anlamlı derecede düşük bulundu. Minör komplikasyon (Klavien 1-3) oranları SA ve GA grubu için sırasıyla%18 ve %12 idi (P> 0.05). Sonuç: SA ile yapılan RIRS, GA ile karşılaştırıldığında aynı taşsızlık ve komplikasyon oranlarına sahip olup, böbrek taşı tedavisinde güvenli ve etkili bir yöntemdir.

Anahtar Kelimeler: Anestezi, spinal; böbrek taşları; üreteroskopi
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