Abstract Context: Percutaneous nephrolithotomy (PCNL) under general anesthesia plays a major role in larger size kidney stones, but in many times spinal anesthesia will be more advantageous owing to better hemodynamic stability and also equally effective in relieving pain. Aim: The aim of this current study is to compare the safety and effectiveness of spinal anesthesia with general anesthesia in percutaneous nephrolithotomy. Settings and Design: It is a randomized prospective study done in MelmaruvathurAdhiparasakthi Institute of Medical sciences and research from April 2016 to April 2018. Methods and Material: 100 patients who were undergoing PCNL were randomly selected and divided into two groups. Group SA (n=50) received total dose 3.4 ml of 0.5% hyperbaric Bupivacaine with 0.6mg of Nalbuphine. Group GA (n=50) received premedication with Glycopyrolate and Fentanyl and they were anesthetised with Propofol and Succcinylcholine Anesthesia was maintained with Vecuronium and N 2O/O2/Isoflurane. Heart rate, mean arterial blood pressure and complications like hypotension, bradycardia were recorded
intraoperatively and postoperatively. Statistical analysis used: Statistical analysis were calculated with the graph pad prism 5.0 software. The data were expressed as a mean and standard deviation.All the quatitative variables were analysed using Unpaired ttest. Results: Pulse rate at 5, 10, 45, 60 minutesintra operatively and at 0, 3, 5 hours postoperatively were significantly less in patients receiving spinal anesthesia group when compared to general anesthesia group (p<0.0001). Mean arterial pressure at 5, 10, 15, 20, 25, 30, 45, 60 minutes intra operatively and at 0, 3, 5 hours postoperatively was found to be less in spinal anesthesia group then the GA group (p< 0.0001). The VAS score at 0, 3, 5, 8 hours was found to be less and statistically significant in spinal anesthesia group as compared to general anaesthsia group (0.66±0.51/4.14±0.75, 1.38±0.49/5.4±0.61, 1.8±0.45/4.32±0.47, 3.78±0.58/4.34±0.47). Moreover analgesic requirement of tramadol more than 100mg was lower in SA group than GA group. Conclusions: Our study shows that spinal anesthesia for PCNL is relativelysafe and equally effective alternative to general
anesthesia with better hemodynamic stability, lower postoperative pain, minimal analgesic requirements, and early recovery.