A Clinical Study to Compare Efficacy and Safety of Combined Spinal-Epidural Anaesthesia over General Anaesthesia for Percutaneous Nephrolithotomy

To compare the efficacy and safety of combined spinal epidural anaesthesia (CSE) over general anaesthesia (GA) in patients undergoing percutaneous nephrolithotomy (PCNL).

Randomized study conducted on 50 patients divided into two groups; Group I (n=25) received GA and group II (n=25) received CSE.

Fifty patients of either sex in the age group of 20–60 years belonging to American Society of Anesthesiologists (ASA) physical status class I or II, scheduled for PCNL in prone position were included in the study. Patients were randomly divided into two group of 25 each; Group I received GA and group II received CSE. Demographic profile, stone characteristic, time to turn patient prone, haemodynamic changes in prone position, haemoglobin, haematocrit, serum electrolyte changes, patient and surgeon satisfaction and incidence of complications were compared in both the groups.

Heart rate increased in both the groups in prone position, but the increase was significantly higher in group I than group II (p=0.002). Mean arterial pressure also was significantly higher in group I as compared to group II (p=0.006). The time required in turning the patient to prone position too was higher in group I than group II (p<0.05). The haemoglobin, haematocrit and serum electrolyte changes were comparable in both groups. The surgeon satisfaction and complications were comparable in both the groups but patient satisfaction was significantly higher in group II (p=0.05) than group I.

CSE for PCNL is an effective and safe method. It has significantly better hemodynamic stability and patient satisfaction as compared to general anaesthesia.