Efficacy and Safety of Percutaneous Nephrolithotomy (PCNL): A Comparative Study between General Anesthesia and Spinal Anesthesia

Abstract

Background: Percutaneous nephrolithotomy (PCNL) can be conducted under general anesthesia as well as spinal anesthesia. To compare the efficacy and safety of spinal anesthesia vs. general anesthesia in PCNL. Materials and Methods: This observational study included 160 patients who underwent PCNL for renal stone from January 2021 to July 2025; 75 received general anesthesia (GA group) and 85 spinal anesthesia (SA group). Demographic and operative variables, including age, stone size, number and location, pre- and postoperative hemoglobin and hematocrit, postoperative pain, analgesic requirement, hospital stay, complications and stone-free rate, were compared. Results: The groups were comparable in age, stone size, number and location. Peri-operative hypotension was significantly higher in the SA group than the GA group (19.27% vs. 6.6%, p=0.023), while postoperative fever was higher in the GA group (58.66% vs. 38.22%, p=0.018). Shivering was higher in the SA group (15.29% vs. 5.34%), whereas nausea and vomiting were higher in the GA group: 16.67% vs. 4.79% (p=0.031) and 13.34% vs. 3.52% (p=0.023), respectively. Mean hospital stay was similar between SA and GA groups (5.30±2.06 vs. 05.02±01.91 days, p=0.37). Hemoglobin, hematocrit and stone-free rate showed no significant difference. Conclusion: In PCNL, spinal anesthesia was associated with more hypotension but less postoperative fever and may be an alternative to general anesthesia with comparable efficacy and safety.

Delta Med Col J. Jan 2023;11(1):28-34