Buldu Ibrahim, Tepeler Abdulkadir, Kaynar Mehmet, Karatag Tuna, Tosun Muhammed, Umutogluv Tarik, Tanriover Hakan, Istanbulluoglu Okan
Department of Urology, Faculty of Medicine, University of Mevlana, Konya 42000, Turkey.
Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34000, Turkey.
Urol J. 2016 Mar 5;13(1):2479-83.
To compare the efficacy and safety of percutaneous nephrolithotomy (PNL) in the treatment of staghorn calculi (SC) under spinal anesthesia (SA) versus general anesthesia (GA).
Patients with SC who treated with PNL from 2011 to 2014 were retrospectively reviewed. In total, 100 patients were divided into 2 groups according to anesthesia type: SA (group 1, n = 47) and GA (group 2, n = 53). Demographics, perioperative parameters, and postoperative analgesic requirements were compared between the two groups.
There was no significant difference in terms of age, sex, American Society of Anesthesiologists score, body mass index, or stone size between the two groups (P = .40, .30, .18, .20, and .50, respectively). The mean procedure times were 84.7 and 87.5 min in the SA and GA groups, respectively (P = .68). The complication rates were similar in the SA and GA groups (19.1% vs. 13.2%, respectively; P = .421). The stone-free rates were also similar in the SA and GA groups (61.7% vs. 52.8%, respectively; P = .374). No statistically significant difference was found in analgesic requirements.
SA is a safe method without the risks of GA and may be used for conditions in which GA is contraindicated or in patients with concerns about GA. Our outcomes indicated that SC can be treated safely and effectively under SA.
比较脊髓麻醉（SA）与全身麻醉（GA）下经皮肾镜取石术（PNL）治疗鹿角形结石（SC）的疗效和安全性。
回顾性分析2011年至2014年接受PNL治疗的SC患者。根据麻醉类型将100例患者分为两组：SA组（第1组，n = 47）和GA组（第2组，n = 53）。比较两组患者的人口统计学、围手术期参数和术后镇痛需求。
两组患者在年龄、性别、美国麻醉医师协会评分、体重指数或结石大小方面无显著差异（P值分别为0.40、0.30、0.18、0.20和0.50）。SA组和GA组的平均手术时间分别为84.7分钟和87.5分钟（P = 0.68）。SA组和GA组的并发症发生率相似（分别为19.1%和13.2%；P = 0.421）。SA组和GA组的结石清除率也相似（分别为61.7%和52.8%；P = 0.374）。在镇痛需求方面未发现统计学显著差异。
SA是一种无GA风险的安全方法，可用于GA禁忌或对GA有顾虑的患者。我们的结果表明，在SA下可以安全有效地治疗SC。
