Objective: The study was undertaken to compare the relative efficacy and complications of general versus spinal anesthesia in patients undergoing PCNL.

Materials and Methods: In this observational study, patients undergoing PCNL were divided into two equal groups of 30 patients each. In group A, spinal anesthesia was administered by injecting bupivacaine and fentanyl in subarachnoid space (L3-L4) in sitting position, a ureteral catheter was placed in lithotomy position, head of the bed was tilted down for 5-10 min and the level of anesthesia checked and PCNL done with standard technique. In group B, PCNL was done using standard technique under general anesthesia.

Results: Mean stone size in group A and B was 16.5+6.9mm and 14.4+5.3mm, respectively. Intraoperative hypotension was more in spinal group than the general group with an insignificant difference. There was no transfusion needed intraoperatively. Mean operative time was 68.4+18.71minutes and 90.3+8.70 minutes in spinal and general anesthesia groups, respectively which was statistically significant (p<0.05). Total amount of analgesics required were 132.5+54.0mg of diclofenacin spinal group and 235+38.06 mg of diclofenac in general anesthesia group which was again statistically significant (p<.05). Check x-ray KUB revealed complete clearance of stone regardless of technique of anesthesia used..

Conclusion: The results of this study showed that spinal anaesthesia using lumbar subarachnoid block is a safe, effective and convenient alternative method for performing PCNL in adult patients; avoiding complications of general anesthesia; decreasing need of postoperative analgesics and short duration of surgery.

Keywords: spinal anesthesia, percutaneous nephrolithotomy.

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Dr Muqtasid Rashid

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