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Volume 4 Issue 6 (November - December, 2016)

Original Articles

ASSESSMENT OF VARIOUS ANAESTHETIC TECHNIQUES FOR THE TREATMENT OF SUPINE PERCUTANEOUS NEPHROLITHOTRIPSY- A COMPARATIVE STUDY
Ajay Batra

Background: One of the common methods employed nowadays foe the treatment of renal and urinary stones is PNCL which is a choice modality in large, multiple, and stag-horn stones. In patients with failed shock and endoscopic trials also, PNCL can be used. In about 20% of cases, urologic procedures are undertaken with general anesthesia (GA) or regional anesthesia such as spinal anesthesia (SA). As each type of anesthesia has some advantages and disadvantages and the results of such studies were not entirely consistent and future studies are required. Hence; we comparatively evaluated the quality and efficiency of Continuous Spinal Anesthesia (CSA) and Combined Spinal Epidural Anesthesia (CSE) in supine PCNL. Materials & methods: A total of 80 patients were included in the present study. All the patients reporting to the department of Urology from 2012 to 2014 were included in the present study. Ethical approval was taken from the institutional ethical committee and written consent was obtained from all the patients after explaining them in written the entire research protocol. Patients were randomly allocated to either CSA group or CSE group according to a computer-generated list made before the start of the study. Patients were pre-medicated with suitable medicines and intra-venous access was gained. All procedures were carried out in prone position. Pre-operative parameters included patients’ demographics, ASA status, body mass index and stone size. Intra-operative parameters included recording of pulse, blood pressure at basal level and every 15 min till the end of procedure. Any conversion from spinal to general anesthesia was documented and the patient was excluded from the study. The blockade consisted of performing a spinal block by a 27-G spinal needle that was introduced through a Touhy needle 18-G. Recording of the post-surgical complications was done. All the results were analyzed by SPSS software. Results: Mean age of the patients in group A and group B was 33.5 and 31.5 years respectively. Non-significant results were obtained while comparing the p-values for the mean age, mean body weight and all other demographic details of the patients. Mean duration of surgery in group A and group B patients was 96 and 99 minutes respectively. Significant difference was obtained between the patients of group A and group B while comparing the total ephedrine delivered to the patients in both the groups. Conclusion: In terms of effectiveness and safety, both the techniques are equally good for treatment of patients with PCNL in the supine position.
Key words: Anaesthesia, Nephrolithotripsy, Spinal

 
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