title: Anesthetic considerations during percutaneous nephrolithotomy.
abstract: OBJECTIVE
  To assess anesthesia-related complications during and following percutaneous nephrolithotomy (PCNL) for staghorn stones.
  
  
  METHODS
  Prospective study and a detailed case report.
  
  
  METHODS
  Medical center in southern Israel.
  
  
  METHODS
  20 consecutive patients undergoing PCNL for staghorn stones.
  
  
  METHODS
  All patients underwent PCNL during general anesthesia.
  
  
  METHODS
  Duration of surgery, esophageal temperature, hemoglobin (Hb) concentration, and requirements for blood transfusion, mean volume of irrigation fluid, and serum sodium and potassium concentration were recorded.
  
  
  RESULTS
  Mean age was 50.7 +/- 14.9 y (range, 26-76 y). Mean duration of the procedure was 120.0 +/- 42.5 min (range, 75-240 min). Mean volume of irrigation fluid was 34.1 +/- 15.3 L (range, 18-80 L). There was a significant decrease in Hb concentration from 13.7 +/- 1.71 to 12.2 +/- 1.4 g/dL, but no patient required blood transfusion. There was a statistically significant reduction in esophageal temperature from 36.4 degrees C +/- 0.32 degrees C to 35.2 degrees C +/- 0.5 degrees C. There were no significant changes in sodium or potassium concentration before or after PCNL.
  
  
  CONCLUSIONS
  Anesthesia during PCNL for staghorn stones is a challenge because of the possibility of fluid absorption, dilutional anemia, hypothermia, or significant blood loss.
authors.affiliation: Division of Anesthesiology, Department of Urology, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel. amaliaro@012.net.il
authors.forename: Vsevolod
authors.initials: V
authors.lastname: Rozentsveig
authors.forename: Endre Z
authors.initials: EZ
authors.lastname: Neulander
authors.forename: Efim
authors.initials: E
authors.lastname: Roussabrov
authors.forename: Andrei
authors.initials: A
authors.lastname: Schwartz
authors.forename: Leonard
authors.initials: L
authors.lastname: Lismer
authors.forename: Boris
authors.initials: B
authors.lastname: Gurevich
authors.forename: Yosef
authors.initials: Y
authors.lastname: Klein
authors.forename: Natan
authors.initials: N
authors.lastname: Weksler
mesh_terms: D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D011446:Prospective Studies; D016896:Treatment Outcome