• Logo
  • SBMUJournals

Comparison of Two Different Anesthesia Methods in Patients Undergoing Percutaneous Nephrolithotomy

Mehmet Solakhan, Ersan Bulut, Mehmet Sakip Erturhan



Purpose: The study aims to compare the effectiveness, safety and costs of two different anesthesia methods in percutaneous nephrolithotomy (PCNL) operations.

Material and Method: In our study, data was retrospectively examined of 1657 patients who underwent PCNL due to renal calculi between 2009 and 2017. Patients were separated into two groups according to the type of anesthesia; as those who underwent PCNL by general anesthesia (GA) (n = 572) and those under spinal anesthe­sia(SA) (n = 1085). Standard PCNL technique was used in both groups. Gender, age, operation duration, period of hospitalization, stone-free ratio, post-operative narcotic analgesic need and complications were compared between these two groups.

Results: A total of 1657 patients consisting of 1064 (64.2%) male patients and 593 (35.8%) female patients were included in the study. The average age of the all patients was 33.2 ± 12.4 (range 16-74) years. The two groups were similar in terms of mean age, gender, stone size, stone location and body mass index. Mean operation time was sig­nificantly shorter in the SA group than in the GA group (81.8 ± 33.9 minute vs. 118.2 ± -42.9 minute respectively, P < .001). Mean period of hospitalization was remarkable shorter in the SA group than in the GA group (30.0 ± 9.9 hours vs. 38.4 ± 11.2 hours respectively, P < .001). Post-operative narcotic analgesic need rate was significantly higher in the GA group than in the SA group (33.4% vs. 10.9%, respectively, P < .001). Anesthesia cost was found significantly lower in the SA group than in the GA group (USD 21.3±2.8 vs. USD 83.6 ± 9.5, respectively, P < .001). Significant difference was not observed between both groups in terms of stone-free ratio, amount of bleed­ing, fluoroscopy time, pre-operative and post-operative complications.

Conclusion: Compared to those performed with GA, PCNL performed with SA is a safe, effective and low-cost method.



Fernstrom I, Johansson B. Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol. 1976;10:257-9.

Ramakumar S, Segura JW. Renal calculi. Percutaneous management. Urol Clin North Am 2000;27:617-22.

LingemanJE, Matlaga BR, Evan AP. Surgical management of upperurinary tract calculi. In: Wein AJ, Kavoussi LR, Novick AC, et al.,eds. Campbell-Walsh Urology. ed. 9th vol. 2. Philadelphia: Saunders Elsevier; 2007:1431-1507.

Mehrabi S, Shirazi KK. Results and complications of spinal anesthesiain percutaneous nephrolithotomy. Urol J. 2010;7:22-25.

Aravantinos E, Karatzas A, Gravas S, Tzortzis V, Melekos M. Feasibility of percutaneous nephrolithotomy under assisted local anaesthesia: a prospective study on selected patients with upper urinary tract obstruction. Eur Urol. 2007;51:224-7

Kuzgunbay B, Turunc T, Akin S, et al. Percutaneous nephrolithotomyunder general versus combined spinal-epidural anesthesia. J Endourol. 2009;23:1-5.

Singh V, Sinha RJ, Sankhwar SN, et al. A prospective randomized study comparing percutaneous nephrolithotomy under combinedspinal-epidural anesthesia with percutaneous nephrolithotomy under general anesthesia. Urol Int. 2011;87:1-6.

Rozentsveig V, Neulander EZ, Roussabrov E, et al. Anesthetic considerations during percutaneous nephrolithotomy. J.Clin Anesth. 2007;19:351-5.

Trivedi NS, Robalino J, Shevde K. Interpleural block: a new technique for regional anaesthesia during percutaneousnephrostomy and nephrolithotomy. Can J Anaesth.1990;37:479-81.

El-Husseiny T, Moraitis K, Maan Z, et al. Percutaneous endourologic procedures in high-risk patients in the lateraldecubitus position under regional anesthesia. J Endourol.2009;23:1603-6.

Tangpaitoon T, Nisoog C, Lojanapiwat B. Efficacy and safety of percutaneous nephrolithotomy (PCNL): a prospective and randomized study comparing regional epidural anesthesia with general anesthesia. Int Braz J Urol. 2012;38:504-511.

Karacalar S, Bilen CY, Sarihasan B, et al. Spinal-epidural anesthesia versus general anesthesia in the management of percutaneous nephrolithotripsy. J Endourol. 2009;23:1591-1597.

Pu C, Wang J, Tang Y, Yuan H, Li J, Bai Y, Wang X, Wei Q, Han P. The efficacy and safety of percutaneous nephrolithotomy under general versus regionalanesthesia: a systematic review and meta-analysis. Urolithiasis 2015 Oct;43(5):455-66.

de la Rosette JJ, Zuazu JR, Tsakiris P, et al. Prognostic factors and percutaneous nephrolithotomy morbidity: a multivariate analysis of a contemporary series using the Clavien classification. J Urol. 2008;180:2489-2493).

Tefekli A, Karadag MA, Tepeler K, et al. Classification of percutaneous nephrolithotomy complications using the modified Clavien grading system: looking for a standard. Eur Urol. 2008;53:184-190.

Zencirci B. Postdural puncture headache and pregabalin. J Pain Res. 2010;3:11-14.

Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth. 2003;91:718-729.

Karakaş HB, Çiçekbilek İ, Tok A, Alışkan T, Akduman B. Comparison of intraoperative and postoperative complications based on ASA risks in patients who underwent percutaneous nephrolithotomy. Turk J Urol. 2016 Sep;42(3):162-7.

DOI: http://dx.doi.org/10.22037/uj.v0i0.4291


  • There are currently no refbacks.