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A Prospective Randomized Comparative Study of Epidural Block and General Anesthesia for Percutaneous Nephrolithotomy for Hemodynamic Stability and Postoperative Analgesia

Sangeetha C., Assistant Professor, Department of Anesthesiology, Rajarajeswari Medical College and Hospital, Kambipura, Mysore Road, Bengaluru, Karnataka 560074, India. , Sowmya M. Jois1 , Sangeetha C.2 , Venkatesh Murthy K.T.3 , Gayathri M. Mashar4 , Padmakar5

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Indian Journal of Anesthesia and Analgesia 5(3):p 419-424, March 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5318.11

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Abstract

Percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure for removal of calculi in pelvicalyceal system which is usually performed under general anaesthesia. We conducted a prospective, randomized, comparative study to compare epidural block and general anesthesia with respect to hemodynamic stability and postoperative analgesia in patients undergoing PCNL. Methods: 80 urological patients of ASA I and II grade,posted for percutaneous nephrolithotomy were included in our study. They were divided into two groups of 40 each. In patients belonging to Group G, surgery was performed under General Anaesthesia and in Group E, surgery was performed under Epidural Anaesthesia using 1.5mg/kg of 0.5% bupivacaine and 1mcg/kg of Fentanyl to a maximum of 50mcg. Intraoperative hemodynamics, postoperative analgesia, amount of rescue analgesic required and patient satisfaction were compared between the two groups. Complications, if any were also compared. Results: In our study, we found that the Heart rate, Mean arterial pressure were increased in the initial 5 minutes after giving General Anaesthesia in patients belonging to Group G when compared to Group E. Time duration of post-operative analgesia was more in Group E with less amount of analgesic requirement than in patients belonging to Group G. Post-operative complications were also less in Group E than in Group G. With the results obtained in our study, we concluded that Epidural anaesthesia is better than General anaesthesia in patients undergoing PCNL.

 

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5318.11

Keywords

Epidural block; General anesthesia; Percutaneous-nephrolithotomy. 

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