A Comparison of Epidural Anesthesia without Motor Block Versus General Anesthesia for Percutaneous Nephrolithotomy

Objective: The study carried out to compare the operative parameters and stone clearance in patients who underwent percutaneous nephrolithotomy (PNL) under epidural anesthesia (EA) without motor block versus those who underwent PNL under general anesthesia (GA). Materials and Methods: We retrospectively reviewed 2 groups of patients who underwent PNL at our institute between January 2014 and September 2014. Group 1 consisted of 69 consecutive patients who underwent PNL under EA without motor block and group 2 consisted of 69 consecutive patients who underwent PNL under GA. Patients general characteristics, stone features, surgical parameters, duration of surgery, time spent in the operating room, postoperative analgesic requirements, complications, stone clearance rate and mean length of hospital stay were compared between the 2 groups. Results: The two groups were similar in terms of mean age, gender, stone size and previous surgery. Operative time, access site, mean access number, postoperative fever, drainage, mean hemoglobin drop, stone-free rate, duration of nephrostomy tube and length of hospitalization were also similar between the groups. The time spent in the operating room, blood transfusion rate and postoperative analgesic requirements in EA group were significantly lower than those in GA group. Conclusion: PNL under EA without motor block is as effective and safe as PNL under GA and it offers some advantages as with lower parenteral analgesic requirements, lower transfusion rates and lesser usage of operation room.

Perkütan Nefrolitotomide Motor Bloksuz Epidural Anestezi ile Genel Anestezinin Karşılaştırılması

Amaç: Çalışma, motor bloksuz epidural anestezi (EA) altında perkütan nefrolitotomi (PNL) uygulanan hastalara karşı genel anestezi (GA) uygulanan hastaların operasyon parametrelerini ve taş temizlenmesini karşılaştırmak için yürütülmüştür. Gereç ve Yöntem: Ocak 2014 ile Eylül 2014 tarihleri arasında kliniğimizde PNL uygulanan iki grup geriye dönük olarak incelendi. Grup 1, motor bloksuz EA uygulanan ardışık 69 hasta ve grup 2 de GA altında PNL uygulanan ardışık 69 hastadan oluştu. İki grup arasında hastaların genel özellikleri, taş özellikleri, cerrahi parametreler, ameliyat süresi, ameliyat odasındaki süre, postoperatif analjezik gereksinimleri, komplikasyonlar, taş temizleme oranı ve ortalama hastanede kalış süreleri karşılaştırıldı. Bulgular: İki grup arasında yaş, cinsiyet, taş boyutu ve daha önce yapılan cerrahi açısından benzerlik vardı. Her iki grupta da operasyon süresi, erişim yeri, ortalama erişim sayısı, ameliyat sonrası ateş, drenaj, ortalama hemoglobin düşmesi, taşsızlık oranı, nefrostomi süresi ve hastanede yatış süresi benzerdi. Ameliyat odasında geçen süre, kan transfüzyon oranı ve EA grubundaki postoperatif analjezik gereksinimleri GA grubundakilere göre anlamlı derecede düşüktü. Sonuç: Motor bloksuz EA ile yapılan PNL, GA altındaki PNL kadar etkili ve güvenlidir olup daha az parenteral analjezik gerekliliği, daha düşük transfüzyon oranları ve ameliyat odasının daha kısa süreli kullanımı gibi bazı avantajlar sunmaktadır.

Kaynakça

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