Comparison of different methods of anesthesia for flexible ureteroscopy with holmium laser lithotripsy in the treatment of renal calculi

doi:10.3877/cma.j.issn.1674-3253.2018.01.009

Abstract

Abstract:

Objective

To observe and compare the safety and efficacy of combined spinal epidural anesthesia (CSEA) and general anesthesia with endotracheal intubation (GA) for flexible ureteroscopywith holmium laser lithotripsy.

Methods

A total of 80 patients with renal calculi treated in Dongguan City Nancheng Hospital, between December 2015 and May 2016 were randomly assigned to CSEA group and GA group. Flexible ureteroscopy with holmium laser lithotripsy was performed in both groups. Changes in the intraoperative blood pressure and heart rate of the patients between the two groups, as well as rehydration, use of vasopressor drugs, operation time, and intraoperative discomfort were compared.

Results

After anesthesia and during operation, the blood pressure decreased significantly and the heart rate increased in CSEA group (P<0.05), which needed to speed up rehydration and use of vasopressor drugs. In contract, patients in GA group presented no obvious change and body movement, and their breath were controlled well, making it easy to perform operation; uncomfortable reaction rate of the patients was lower than that of CSEA group (P<0.05).

Conclusion

Compared with CSEA, GA is more comfortable, safer and easier to perform flexible ureteroscopy with holmium laser lithotripsy in the treatment of renal calculi.

Key words: Renal calculi, Anesthesia, Flexible ureteroscopy, Holmium laser

Hanxin Peng, Chulian Gong, Chaojin Chen, Tao Zhang. Comparison of different methods of anesthesia for flexible ureteroscopy with holmium laser lithotripsy in the treatment of renal calculi[J]. Chinese Journal of Endourology(Electronic Edition), 2018, 12(01): 31-34.

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References 16

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指标	例数	MAP（mmHg）			HR（次/min）			SpO₂（%）
指标	例数	术前	术中	术后	术前	术中	术后	术前	术中	术后
GSEA组	40	111±15	092±10^*	098±10	77±20	092±13^*	083±11	097±2	094±1^*	098±1
GA组	40	112±14	109±12^*	116±15	79±18	080±11^*	082±12	097±3	098±1^*	097±2

指标	例数	MAP（mmHg）			HR（次/min）			SpO₂（%）
指标	例数	术前	术中	术后	术前	术中	术后	术前	术中	术后
GSEA组	40	111±15	092±10^*	098±10	77±20	092±13^*	083±11	097±2	094±1^*	098±1
GA组	40	112±14	109±12^*	116±15	79±18	080±11^*	082±12	097±3	098±1^*	097±2

?	输入液体总量（ml）	升压药使用次数（次）	手术时间（min）	体动发生率（%）	进镜困难发生率（%）	术中患者不适发生率（%）
CSEA组	1 450±189	2.3±0.5	55±11	58.31	12.32	31.20
GA组	420±850	0.8±0.3	40±90	00.00	005.61	00.00
P值	<0.001	0.001	<<0.003	<0.001	<0.001	<0.001

?	输入液体总量（ml）	升压药使用次数（次）	手术时间（min）	体动发生率（%）	进镜困难发生率（%）	术中患者不适发生率（%）
CSEA组	1 450±189	2.3±0.5	55±11	58.31	12.32	31.20
GA组	420±850	0.8±0.3	40±90	00.00	005.61	00.00
P值	<0.001	0.001	<<0.003	<0.001	<0.001	<0.001

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