title: Comparison between spinal and general anesthesia in percutaneous nephrolithotomy.
abstract: BACKGROUND
  Hemodynamic stability and blood loss reduction are subjects to further consideration in patients undergoing percutaneous nephrolithotomy (PNCL).
  
  
  OBJECTIVE
  This study compared the preference of spinal anaesthesia (SA) or general anaesthesia (GA) in respect to mentioned concerns.
  
  
  METHODS
  In this randomized clinical trial, 59 patients who underwent PCNL divided into SA and GA groups. 15-20 mg from intra-thecal bupivacaine 0.5%, and premedication of 0.01-0.02 mg from midazolam, were given to patients in SA group (n = 29). Patients in GA group (n = 30) received premedication of 1-2 µg/kg from fentanyl and 0.01-0.02 mg/kg from midazolam, and intravenously anaesthetized with 100 µg/kg/min of propofol and 0.5 mg/kg of atracurium, given by continuous infusion and N2O/O2 50%. Mean arterial pressure (MAP) and heart rate were recorded intra-operatively and during recovery.
  
  
  RESULTS
  MAP and heart rate show no significant differences at designated time points between two groups (P > 0.05). Surgery time, anesthesia time, bleeding volume, and analgesic intake were significantly reduced in SA group (P < 0.05).
  
  
  CONCLUSIONS
  It seems that, in patients undergoing PNCL, SA is as effective and safe as GA. Patients who undergo PNCL under SA require smaller amounts of analgesic dose and show hemodynamic stability during surgery and recovery time. Also, SA technique provides decreased blood loss and shortened surgery as well as anesthesia times compared to GA.
authors.affiliation: Department of Anesthesiology, Shahid Hamsheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Movasseghi
authors.affiliation: Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran ; Department of Anesthesiology and Critical Care, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Valiollah
authors.initials: V
authors.lastname: Hassani
authors.affiliation: Department of Anesthesiology, Shahid Hamsheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahmood Reza
authors.initials: MR
authors.lastname: Mohaghegh
authors.affiliation: Department of Anesthesiology and Critical Care, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Safaeian
authors.affiliation: Department of Anesthesiology and Critical Care, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Safari
authors.affiliation: Department of Anesthesiology and Critical Care, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Mahdi
authors.initials: MM
authors.lastname: Zamani
authors.affiliation: Department of Anesthesiology and Critical Care, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Nabizadeh
keywords: Analgesia; Hemodynamics; Hemorrhage; Nephrostomy, Percutaneous