Anesthesia View in Percutaneous Nephrolithotomy: A 3-year Experienceof a Referral Hospital

Özet

Objective: The aim of this study was to document the use of general anesthesia for patients who underwent percutaneous nephrolithotomy (PNL) during a 3-year period and to exam-ine the current discussion related to anesthesia techniques in the context of the literature.Methods: Patients scheduled for PNL between 2015 and 2017 were assessed retrospec-tively. Patient demographic data, the characteristics of the renal stones, the duration of the operation, blood transfusion requirements, and complications of the PNL procedure and general anesthesia were evaluated.Results: A total of 521 patients were included in this study. The mean age was 48.32±0.61 years. The mean stone size was 22.48±0.47 mm. The mean duration of the operation was 106.30±1.56 minutes, and 79.07% of patients were stone-free after the procedure. The mean fluoroscopy time was 23.30±1.45 seconds and the mean irrigation fluid volume was measured as 8.70±0.23 L. The decrease in the hemoglobin and hematocrit levels after the procedure was statistically significant (p<0.0001), with a transfusion rate of 4.99%. Fever after surgery and hemorrhage not requiring blood transfusion were the major complica-tions (13.4% and 10.74%, respectively) seen, using the Clavien classification system. Difficult intubation (1.2%), post-extubation laryngospasm (2.3%), refractory nausea (1.5%), bron-chospasm (0.38%), ischemic electrocardiography changes (0.19%), and delirium (0.19%) were the major anesthesia problems.Conclusion: General anesthesia is a safe and effective method for PNL with well-known risks. Regional anesthesia techniques have also been reported in PNL procedures as an alter-native to general anesthesia in recent years. Further clinical trials with large patient groups are needed to demonstrate the safety and efficacy of regional anesthesia in PNL.