Anesthetic considerations during percutaneous nephrolithotomy.
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.
Rozentsveig
Vsevolod
V
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
Neulander
Endre Z
EZ
Roussabrov
Efim
E
Schwartz
Andrei
A
Lismer
Leonard
L
Gurevich
Boris
B
Klein
Yosef
Y
Weksler
Natan
N
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