Results of Percutaneous Nephrolithotomy under Spinal Anesthesia
Recently, there has been a considerable increase in the
number of procedures carried out under regional anesthesia.
However, percutaneous nephrolithotomy (PCNL) procedures are
usually performed under general anesthesia. The aim of this study
was to assess the safety and efficacy of PCNL under spinal anesthesia
in patients with renal calculi. We describe our 9 years experience of
performing PCNL under spinal anesthesia for 387 patients with large
stones of the upper urinary tract, with regard to the effectiveness and
side effects. All patients received spinal anesthetics (Lidocain 5%, or
Bupivacaine 0.75%) and underwent PCNL in prone position. The
success rate was 94.1%. The incidence of complications was 11.6%.
PCNL under spinal anesthesia is feasible, safe, and well-tolerated in
management of patients with renal stones.
[1] I. Fernström, B. Johansson, "Percutaneous Nephrolithotomy: A new
extraction technique" Scand J Urol Nephrol, vol. 10, pp. 257-259,
1976.
[2] MY. Wong, "Evolving technique of Percutaneous Nephrolithotomy in a
developing country: Singapore General Hospital experience" J
Endourol, vol. 12, pp. 397-401, Oct 1998.
[3] A. Basiri, S. Mehrabi, H. Kianian, A. Javaherforooshzadeh, "Blind
puncture in comparison with fluoroscopic guidance in Percutaneous
Nephrolithotomy: a randomized controlled trial" Urol J, vol. 4, pp. 79-
83, Spring 2007.
[4] JW. Segura, GM. Preminger, DG. Assimos, et al, "Nephrolithiasis
Clinical Guidelines Panel summery report on the management of
staghorn calculi" Urol J, vol. 151, pp. 1648, Jun 1994.
[5] I. Singh, A. Kumar, P. Kumar, "Ambulatory PCNL" (tubeless PCNL
under regional anesthesia) - a preliminary report of 10 cases" Int Urol
Nephrol, vol. 37, pp. 35-37, 2005.
[6] DL. Brown, "Spinal, Epidural, and caudal Anesthesia" in Miler's
Anesthesia, 7th ed. vol. 1, RD. Miller, LI. Eriksson, LA. Fleisher, JP.
Wiener-Kronish, WL. Young, Ed. Philadelphia, Churchill Livingstone
Elsevier, 2010; pp: 1611-1638.
[7] NS. Trivedi, J. Robalino, K. Shevde, "Interpleural block: A new
technique for regional anesthesia during percutaneous nephrostomy and
Nephrolithotomy" Can J Anaesth, vol. 37, pp. 479-481, May 1990.
[8] MM. Saied, ZM. Sonbul, M. el-Kenawy, et al, "Spinal and interpleural
Bupivaccaine for percutaneous Nephrolithotomy" Middle East J
Anesthesiol, vol. 11, pp. 259-264, Oct 1991.
[9] C. Andreoni, EO. Olweny, AJ. Portis, CP. Sundaram, T. Monk, RV.
Clayman, "Effect of single-dose subarachnoid spinal anesthesia on pain
and recovery after unilateral percutaneous nephrolithotomy" J Endourol,
vol. 16, pp. 721-725, Dec 2002.
[10] E. Aravantinos, A. Karatzas, S. Gravas, V. Tzortzis, M. Melekos,
"Feasibility of percutaneous nephrolithotomy under assisted local
anesthesia: a prospective study on selected patients with upper urinary
tract obstruction" Eur Urol, vol. 51, pp. 224-227, Jan 2007.
[11] V. Rozentsveig, EZ. Neulander, E. Roussabrov, et al, "Anesthetic
considerations during percutaneous nephrolithotomy" J Clin Anesth,
vol. 19, pp. 351-355, Aug 2007.
[12] V. Ballestrazzi, C. Zboralski, P. Smith-Morel, M. Boullet, I. Willot, D.
Hochart, P. Scherpereel, "[Importance of suspended peridural anesthesia
in percutaneous nephrolithotomy. Apropos of 112 patients in the
urology service of the Regional Hospital Center of life.]" (fre) Cah
Anesthesiol, vol. 36, pp. 85-88, Mar-Apr 1988.
[13] T. El-Husseiny, K. Moraitis, Z. Maan, A. Papatsoris, P. Saunders, B.
Golden, J. Masood, NP. Buchholz, "Percutaneous endourologic
procedures in high-risk patients in the lateral decubitus position under
regional anesthesia" J Endourol, vol. 23, pp. 1603-1606, Oct 2009.
[14] B. Kuzgunbay, T. Turunc, S. Akin, P. Ergenoglu, A. Aribogan, H.
Ozkardes, "Percutaneous nephrolithotomy under general versus
combined spinal-epidural anesthesia" J Endourol, vol. 23, pp. 1835-
1838, Nov 2009.
[15] C. Andreoni, EO. Olweny, AJ. Portis, CP. Sundaram, T. Monk, RV.
Clayman, "Effect of single-dose subarachnoid spinal anesthesia on pain
and recovery after unilateral percutaneous nephrolithotomy" J Endourol,
vol. 16, pp. 721-725, Dec 2002.
[16] S. Mehrabi, K. Karimzadeh Shirazi, "Results and complications of
spinal anesthesia in percutaneous nephrolithotomy" Urol J, vol. 7, pp.
22-25, Winter 2010.
[1] I. Fernström, B. Johansson, "Percutaneous Nephrolithotomy: A new
extraction technique" Scand J Urol Nephrol, vol. 10, pp. 257-259,
1976.
[2] MY. Wong, "Evolving technique of Percutaneous Nephrolithotomy in a
developing country: Singapore General Hospital experience" J
Endourol, vol. 12, pp. 397-401, Oct 1998.
[3] A. Basiri, S. Mehrabi, H. Kianian, A. Javaherforooshzadeh, "Blind
puncture in comparison with fluoroscopic guidance in Percutaneous
Nephrolithotomy: a randomized controlled trial" Urol J, vol. 4, pp. 79-
83, Spring 2007.
[4] JW. Segura, GM. Preminger, DG. Assimos, et al, "Nephrolithiasis
Clinical Guidelines Panel summery report on the management of
staghorn calculi" Urol J, vol. 151, pp. 1648, Jun 1994.
[5] I. Singh, A. Kumar, P. Kumar, "Ambulatory PCNL" (tubeless PCNL
under regional anesthesia) - a preliminary report of 10 cases" Int Urol
Nephrol, vol. 37, pp. 35-37, 2005.
[6] DL. Brown, "Spinal, Epidural, and caudal Anesthesia" in Miler's
Anesthesia, 7th ed. vol. 1, RD. Miller, LI. Eriksson, LA. Fleisher, JP.
Wiener-Kronish, WL. Young, Ed. Philadelphia, Churchill Livingstone
Elsevier, 2010; pp: 1611-1638.
[7] NS. Trivedi, J. Robalino, K. Shevde, "Interpleural block: A new
technique for regional anesthesia during percutaneous nephrostomy and
Nephrolithotomy" Can J Anaesth, vol. 37, pp. 479-481, May 1990.
[8] MM. Saied, ZM. Sonbul, M. el-Kenawy, et al, "Spinal and interpleural
Bupivaccaine for percutaneous Nephrolithotomy" Middle East J
Anesthesiol, vol. 11, pp. 259-264, Oct 1991.
[9] C. Andreoni, EO. Olweny, AJ. Portis, CP. Sundaram, T. Monk, RV.
Clayman, "Effect of single-dose subarachnoid spinal anesthesia on pain
and recovery after unilateral percutaneous nephrolithotomy" J Endourol,
vol. 16, pp. 721-725, Dec 2002.
[10] E. Aravantinos, A. Karatzas, S. Gravas, V. Tzortzis, M. Melekos,
"Feasibility of percutaneous nephrolithotomy under assisted local
anesthesia: a prospective study on selected patients with upper urinary
tract obstruction" Eur Urol, vol. 51, pp. 224-227, Jan 2007.
[11] V. Rozentsveig, EZ. Neulander, E. Roussabrov, et al, "Anesthetic
considerations during percutaneous nephrolithotomy" J Clin Anesth,
vol. 19, pp. 351-355, Aug 2007.
[12] V. Ballestrazzi, C. Zboralski, P. Smith-Morel, M. Boullet, I. Willot, D.
Hochart, P. Scherpereel, "[Importance of suspended peridural anesthesia
in percutaneous nephrolithotomy. Apropos of 112 patients in the
urology service of the Regional Hospital Center of life.]" (fre) Cah
Anesthesiol, vol. 36, pp. 85-88, Mar-Apr 1988.
[13] T. El-Husseiny, K. Moraitis, Z. Maan, A. Papatsoris, P. Saunders, B.
Golden, J. Masood, NP. Buchholz, "Percutaneous endourologic
procedures in high-risk patients in the lateral decubitus position under
regional anesthesia" J Endourol, vol. 23, pp. 1603-1606, Oct 2009.
[14] B. Kuzgunbay, T. Turunc, S. Akin, P. Ergenoglu, A. Aribogan, H.
Ozkardes, "Percutaneous nephrolithotomy under general versus
combined spinal-epidural anesthesia" J Endourol, vol. 23, pp. 1835-
1838, Nov 2009.
[15] C. Andreoni, EO. Olweny, AJ. Portis, CP. Sundaram, T. Monk, RV.
Clayman, "Effect of single-dose subarachnoid spinal anesthesia on pain
and recovery after unilateral percutaneous nephrolithotomy" J Endourol,
vol. 16, pp. 721-725, Dec 2002.
[16] S. Mehrabi, K. Karimzadeh Shirazi, "Results and complications of
spinal anesthesia in percutaneous nephrolithotomy" Urol J, vol. 7, pp.
22-25, Winter 2010.
@article{"International Journal of Medical, Medicine and Health Sciences:59224", author = "Babak Borzouei and Seyed Habibollah Mousavi-Bahar", title = "Results of Percutaneous Nephrolithotomy under Spinal Anesthesia", abstract = "Recently, there has been a considerable increase in the
number of procedures carried out under regional anesthesia.
However, percutaneous nephrolithotomy (PCNL) procedures are
usually performed under general anesthesia. The aim of this study
was to assess the safety and efficacy of PCNL under spinal anesthesia
in patients with renal calculi. We describe our 9 years experience of
performing PCNL under spinal anesthesia for 387 patients with large
stones of the upper urinary tract, with regard to the effectiveness and
side effects. All patients received spinal anesthetics (Lidocain 5%, or
Bupivacaine 0.75%) and underwent PCNL in prone position. The
success rate was 94.1%. The incidence of complications was 11.6%.
PCNL under spinal anesthesia is feasible, safe, and well-tolerated in
management of patients with renal stones.", keywords = "percutaneous nephrolithotomy, spinal anesthesia,
renal calculi", volume = "6", number = "5", pages = "163-4", }
