Abstract:
Objective To analyze the effect of local anesthesia combined with intensive anesthesia on minimally invasive percutaneous nephrolithotomy (MPCNL) in treatment of patients with upper urinary tract calculi.
Methods 98 patients with upper urinary calculi who underwent MPCNL in Huizhou First People's Hospital from December 2015 to December 2017 were randomly divided into two groups according to the random number table method. The control group (49 patients) were taken genera anesthesia, the observation group (49 patients) underwent local anesthesia combined with anesthesia. The patient's operation time, hospital stay, double J tube indwelling time, stone clearance rate, renal fistula indwelling time, postoperative adverse reaction status, and serum urea nitrogen (BUN), C-reactive protein (CRP), serum creatinine (Cr), tumor necrosis factor alpha (TNF-α), β2-microglobulin (β2-M), interleukin 6 (IL-6) one day before and 3 days after surgery.
Results The operation time and hospitalization time of the observation group were lower than those of the control group (P<0.05). There was no significant difference between the two groups in stone removal rate, double J tube indwelling time and renal fistula indwelling time (P>0.05). The levels of serum CRP, TNF-α and IL-6 3 days after operation in the two groups were significantly higher than those in the 1 day before operation (P<0.05). The increase in the observation group was lower than that in the control group. There were no significant differences in the levels of β2-M, Cr and BNU between the two groups on the 1 day before surgery and 3 days after operation (P>0.05). The total adverse reaction rate in the observation group was 14.29%, which was lower than the control group of 30.61% (P<0.05).
Conclusion MPCNL under local anesthesia combined with intensive anesthesia can effectively reduce postoperative adverse reactions, serum inflammatory response and hospitalization time, but caution should be taken in case selection, preoperative preparation and intraoperative monitoring should be sufficient.
Key words:
Percutaneous nephrolithotomy,
Urinary tract stones,
Local anesthesia,
General anesthesia,
Prospective study
Jinhua Zheng, Jindong Xie, Jingyu Chen, Yongping Huang. Clinical study of minimally invasive percutaneous nephrolithotomy under local anesthesia combined with intensive anesthesia in the treatment of upper urinary tract calculi[J]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(04): 263-266.