PERCUTANEOUS NEPHROLITHOTOMY WITH EPIDURAL ANAESTHESIA

Introduction: Percutaneous nephrolithotomy (PNL) is a minimal invazive surgery for the treatment of renal stones. For some surgical procedures, epidural anaesthesia is used in patients who can not tolerated general anaesthesia due to severe lung disease. In this study, we aimed to compare general anesthesia with epidural anesthesia during PNL. Materials and Methods: Between July 2007 and January 2008, 40 patients who treated with PNL were included the study. Pediatric age group, patient who have large stones over 1000 mm(2) because of long operation time and patient who have not high intellectual status were excluded from the study. Two groups were identified regarding anaesthesia, general anaesthesia (group 1: 20 patients) and epidural anaesthesia (group 2: 20 patients). Epidural anaesthesia was performed through T12-L1 or L1-2 intervertebral space by 2 ml 2% lidocaine injection and maintained with 15 mg hyperbaric bupivacaine and 20 mg phentanyl. Two groups were compared in term of patients age, operation time, access number, scopy time, stone-free rates, complication rate, postoperative analgesia requiring and hospitalization time. Results: Patient demographics were comparable in two groups. Mean age of patients managed with the general anaesthesia was 38.5 (17-65) years. Epidural anaesthesia group's mean age was 36.5 (18-55) years. There were no significant differences in term of mean operation time, access number, scopy time, stone-free rates, and hospitalization time (p>0.05). Postoperative analgesia requiring in epidural group was significant less than in general anaesthesia group (p<0.05). Pneumotorax was developed in one patient in general anaestesia group. Patient was placed chest tube and cured for four days with decompressing lung. Conclusion: Epidural anesthesia is a offer, effective and comfortable anaesthesia as well as general anaesthesia during PNL. Epidural anesthesia should be chosen for patients who can not tolerated general anaesthesia for the treatment of renal stones by PNL.