Effect of Spinal and General Anesthesia on Postoperative Pain and Satisfaction in Ureteroscopic Lithotripsy (URSL).

Purpose: This study aimed to compare general anesthesia (GA) with spinal anesthesia (SA) regarding postoperative pain and satisfaction after Ureteroscopic Lithotripsy (URSL) Materials and Methods: Two hundred twenty-nine patients were analyzed in the study. Patients were assigned to two groups - "SA" and "GA." Demographic data, stone characteristics, operation time, and frequency of opioid analgesic use during the admission period were collected from the hospital medical records. Visual Analogue Scale (VAS) score at 6 hours and 24 hours after URSL were recorded. Complications according to the Clavien-Dindo classification and the experience of headaches after surgery (Yes/No) were documented after one month. Participants and surgeons were asked to rate their satisfaction on a scale of 1 to 10.

Results: Of 237 eligible patients, 229 completed the study. The incidence of headaches and VAS score (at 6h and 24h) were significantly higher in the SA group (P < 0.001). The satisfaction of patients and surgeons in the GA group was significantly higher (P < 0.001). Multivariate analysis showed that female gender is associated with lower opioid analgesic use during the admission period (OR = 0.47) and surgery time correlated with frequency of opioid use and headache (OR = 1.12 and OR= 1.11 respectively).

Conclusion: Our findings revealed that GA has a better effect on postoperative pain control after URSL surgery and is associated with higher satisfaction levels for both surgeons and patients.