A Randomized Control Trial to Compare Hemodynamic Parameters of Patients Undergoing Percutaneous Nephrolithotomy Under Combined Spinal-Epidural and General Anesthesia in a Tertiary Hospital.

IF 1.5 Q3 ANESTHESIOLOGY
Ksheerabdhi Sankar, Kuppusamy Anand, Swetha Ramani, Balasubramaniam Gayathri
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引用次数: 1

Abstract

Background and aim: Percutaneous nephrolithotomy (PCNL) under epidural anesthesia has been reported to have few advantages over general anesthesia, like lower postoperative pain and less need for analgesics. There are limited studies on PCNL being performed under neuraxial anesthesia in supine position. Hence the present study was conceived to compare hemodynamic parameters in patients undergoing percutaneous nephrolithotomy (PCNL) in the supine position under combined spinal-epidural with general anesthesia (GA).

Material and methods: A prospective, randomized control trial was conducted among 90 patients who were posted to undergo elective percutaneous nephrolithotomy in the the supine position, after obtaining Institutional Ethical Committee (IEC) approval and CTRI (Clinical Trial Registry - India) registration. Patients were randomly allotted to undergo surgery either under general anesthesia (group GA) or combined spinal epidural anesthesia (group CSE) by computer-generated random number method. Hemodynamic parameters, postoperative analgesic requirement and incidence of blood transfusion were recorded and analyzed.

Results: There was no significant difference between the two groups with respect to gender, ASA grade, surgery duration, calculus size and pulse rate. There was a statistically significant reduction in mean arterial pressure from 5 to 50 minutes of surgery and less incidence of blood transfusion in patients in the CSE group. Patients who underwent PCNL in the supine position under CSE required lesser analgesics postoperatively compared to those under general anesthesia.

Conclusion: Combined spinal epidural analgesia can be used as an alternative to general anesthesia for patients undergoing PCNL in the supine position in view of less MAP and reduced postoperative analgesic and blood transfusion requirement.

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三甲医院经皮肾镜取石术中脊髓-硬膜外联合麻醉与全身麻醉血流动力学参数比较的随机对照试验
背景和目的:据报道硬膜外麻醉下经皮肾镜取石术(PCNL)与全麻相比没有什么优势,比如术后疼痛更低,对镇痛药的需求更少。在仰卧位下,在神经轴麻醉下进行PCNL的研究有限。因此,本研究旨在比较脊髓-硬膜外联合全身麻醉(GA)下仰卧位经皮肾镜取石术(PCNL)患者的血流动力学参数。材料和方法:在获得机构伦理委员会(IEC)批准和CTRI(印度临床试验注册中心)注册后,在90例患者中进行了前瞻性随机对照试验,这些患者在仰卧位接受选择性经皮肾镜取石术。采用计算机生成随机数法将患者随机分为全身麻醉组(GA组)和脊髓硬膜外联合麻醉组(CSE组)。记录并分析血流动力学参数、术后镇痛需求及输血发生率。结果:两组患者在性别、ASA分级、手术时间、结石大小、脉搏率等方面差异无统计学意义。CSE组患者手术后5 - 50分钟平均动脉压降低,输血发生率降低,统计学意义显著。与全麻下的患者相比,在CSE下仰卧位进行PCNL的患者术后需要较少的镇痛药。结论:脊髓硬膜外联合镇痛可作为PCNL患者仰卧位全麻的替代麻醉,可减少MAP,减少术后镇痛和输血需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.30
自引率
0.00%
发文量
12
审稿时长
16 weeks
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