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脊髓麻醉能否作为逆行性肾内手术的一种选择?

Could spinal anesthesia be a choice for retrograde intrarenal surgery.

作者信息

Karabulut Ibrahim, Koc Erdem, Yilmaz Ali Haydar, Ahiskali Elif Oral, Keskin Ercument, Adanur Senol, Resorlu Berkan

机构信息

1 Department of Urology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.

2 Department of Urology, Ankara Yildirim Beyazit University, Ankara, Turkey.

出版信息

Urologia. 2018 Nov;85(4):169-173. doi: 10.1177/0391560318758936. Epub 2018 Apr 10.

Abstract

OBJECTIVE

: In this study, we aimed to compare cases of retrograde intrarenal surgery performed under spinal or general anesthesia through investigating relevant parameters for the first time in the literature.

MATERIAL AND METHOD

: In total, 86 patients with diagnosis of kidney stone who were treated by retrograde intrarenal surgery were included in this randomized controlled prospective study. In total, 43 of these operations were performed under spinal anesthesia (group I) and 43 were performed under general anesthesia (group II). The groups were compared in terms of demographic features, American Society of Anesthesiologists score, duration of operation, complication rates, postoperative visual analogue scale, postoperative hospitalization period, stone-free rates, and cost value ratios.

RESULTS

: There were no significant differences between the two groups in terms of demographic findings, preoperative stone loads, postoperative stone-free rates, complication rates and postoperative hospitalization periods (p > 0.05). Postoperative visual analogue scale scores and cost value ratios were found statistically significantly lower in the spinal anesthesia group (group I) when compared with the general anesthesia group (group II; p < 0.001).

CONCLUSION

: Performing retrograde intrarenal surgery in the presence of spinal anesthesia is equally effective with general anesthesia. Spinal anesthesia also appears to be a more advantageous method due to statistically significantly lower mean postoperative pain scores and treatment cost value ratios.

摘要

目的

在本研究中,我们旨在通过首次在文献中调查相关参数,比较在脊髓麻醉或全身麻醉下进行逆行肾内手术的病例。

材料与方法

本随机对照前瞻性研究共纳入86例诊断为肾结石并接受逆行肾内手术治疗的患者。其中43例手术在脊髓麻醉下进行(第一组),43例在全身麻醉下进行(第二组)。比较两组患者的人口统计学特征、美国麻醉医师协会评分、手术时间、并发症发生率、术后视觉模拟评分、术后住院时间、结石清除率和成本价值比。

结果

两组在人口统计学结果、术前结石负荷、术后结石清除率、并发症发生率和术后住院时间方面无显著差异(p>0.05)。与全身麻醉组(第二组)相比,脊髓麻醉组(第一组)的术后视觉模拟评分和成本价值比在统计学上显著更低(p<0.001)。

结论

在脊髓麻醉下进行逆行肾内手术与全身麻醉同样有效。由于术后平均疼痛评分和治疗成本价值比在统计学上显著更低,脊髓麻醉似乎也是一种更具优势的方法。

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