title: Efficacy and safety of percutaneous nephrolithotomy (PCNL): a prospective and randomized study comparing regional epidural anesthesia with general anesthesia.
abstract: OBJECTIVE
  To compare the efficacy and safety of regional epidural anesthesia and general anesthesia in patients who underwent PCNL.
  
  
  METHODS
  Fifty patients submitted to percutaneous nephrolithotomy (PCNL) were randomized into two groups: Group I (N = 26) received general anesthesia and Group II (N = 24) received regional epidural anesthesia. Demographic and operative data including age, BMI, stone position, stone size, postoperative pain, amount of postoperative analgesic usage, length of hospital stay, patient satisfaction, preoperative and postoperative hemoglobin and hematocrit, adverse effects and surgical complications were compared between both groups.
  
  
  RESULTS
  Average pain score at 1 hour. was 6.88 in group I and 3.12 in group II (p < 0.001), at 4 hours. 5.07 in group I and 3.42 in group II (p = 0.025). Less morphine was required in the regional epidural anesthesia group compared to the general anesthesia group. Higher satisfaction was found in the regional epidural group. 6 (23.07 %) patients in Group I and 1 patient (4.19 %) in Group II had postoperative nausea and vomiting, respectively (p = 0.05). Pain score at 12 hours, 24 hours, 48 hours, 72 hours, preoperative and postoperative hemoglobin and hematocrit, length of hospital stay, and adverse effects were no different between the two groups.
  
  
  CONCLUSIONS
  Regional epidural anesthesia is an alternative technique for PCNL which achieves more patient satisfaction, less early postoperative pain and less adverse effects from medication with the same efficacy and safety compared to general anesthesia.
authors.affiliation: Division of Urology, Department of Surgery and Department of Anesthesiology, Faculty of Medicine, Chaing Mai University, Thailand.
authors.forename: T
authors.initials: T
authors.lastname: Tangpaitoon
authors.forename: C
authors.initials: C
authors.lastname: Nisoog
authors.forename: B
authors.initials: B
authors.lastname: Lojanapiwat
mesh_terms: D000328:Adult; D000368:Aged; D000765:Anesthesia, Conduction / Q000379:methods; D000767:Anesthesia, Epidural / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D011184:Postoperative Period; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome