Comparison of the effects of general, spinal and epidural anesthesia on ureter access and surgical outcomes during flexible ureterorenoscopy for transurethral single stone removal surgeries: a monocentric retrospective study
AbstractBackground In ureterorenoscopy, anaesthesiologists are preferring regional anaesthesia to avoid postoperative complications, while surgeons are preferring general anaesthesia to avoid ureteral trauma. China has not published its guidelines and not referring to the European Association of Uro...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2021-01-01
|
| Series: | Annals of Medicine |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2021.1998596 |
| _version_ | 1827579154637258752 |
|---|---|
| author | Haoliang Cai Xiaohui Wu Xi Chen Wenting Chen |
| author_facet | Haoliang Cai Xiaohui Wu Xi Chen Wenting Chen |
| author_sort | Haoliang Cai |
| collection | DOAJ |
| description | AbstractBackground In ureterorenoscopy, anaesthesiologists are preferring regional anaesthesia to avoid postoperative complications, while surgeons are preferring general anaesthesia to avoid ureteral trauma. China has not published its guidelines and not referring to the European Association of Urology guidelines. The objectives of study were to evaluate the effects of general, spinal, and epidural anaesthesia on ureter access and surgical outcomes of ureterorenoscopy.Methods Charts of a total of 392 patients with the American Society of Anaesthesiologists grade I or II, and underwent flexible ureterorenoscopy for removal of the proximal, middle, or distal ureteral single stone under general anaesthesia (GA group; n = 145) or spinal anaesthesia (SA group; n = 131) or epidural anaesthesia (EA group; n = 116) were reviewed retrospectively.Results The dilatation time for patients of GA group was fewer than those of SA (104.01 ± 12.77 sec/patient vs. 130.55 ± 22.53 sec/patient, p < .0001, q = 17.0350) and EA (104.01 ± 12.77 sec/patient vs. 147.03 ± 18.76 sec/patient, p < .0001, q = 26.7240) groups. The time to reach to stone for patients of GA group was fewer than those of SA (126.68 ± 12.59 sec/patient vs. 137.60 ± 17.84 sec/patient, p < .0001, q = 8.4510) and EA (126.68 ± 12.59 sec/patient vs. 149.44 ± 14.85 sec/patient, p < .0001, q = 17.0350) groups. The lithotripsy time (p = .359), operation time (p = .449), intraoperative complications (p = .058), and length of hospital stays (p = .057) of patients were same among groups. Visual analog scale pain scores of patients of the GA group found higher among groups. General anaesthesia caused nausea and vomiting.Conclusions This study suggests general anaesthesia for flexible ureterorenoscopy if there is no contraindication.KEY MESSAGEGeneral anaesthesia facilitates early dilatation of ureters and access to the stone.No strong correlation of the anaesthesia method of choice with lithotripsy time, operation time, intraoperative complications, stone-free conditions, and length of hospital stays.Epidural and spinal anaesthesia have advantages of fewer postoperative pain and better postoperative outcomes for flexible ureterorenoscopy. |
| first_indexed | 2024-03-08T21:57:41Z |
| format | Article |
| id | doaj.art-0993e64f427940ccae8082f47b5f1d77 |
| institution | Directory Open Access Journal |
| issn | 0785-3890 1365-2060 |
| language | English |
| last_indexed | 2024-03-08T21:57:41Z |
| publishDate | 2021-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj.art-0993e64f427940ccae8082f47b5f1d772023-12-19T16:46:27ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602021-01-015312110211910.1080/07853890.2021.1998596Comparison of the effects of general, spinal and epidural anesthesia on ureter access and surgical outcomes during flexible ureterorenoscopy for transurethral single stone removal surgeries: a monocentric retrospective studyHaoliang Cai0Xiaohui Wu1Xi Chen2Wenting Chen3Department of Anesthesiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Anesthesiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Anesthesiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Anesthesiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaAbstractBackground In ureterorenoscopy, anaesthesiologists are preferring regional anaesthesia to avoid postoperative complications, while surgeons are preferring general anaesthesia to avoid ureteral trauma. China has not published its guidelines and not referring to the European Association of Urology guidelines. The objectives of study were to evaluate the effects of general, spinal, and epidural anaesthesia on ureter access and surgical outcomes of ureterorenoscopy.Methods Charts of a total of 392 patients with the American Society of Anaesthesiologists grade I or II, and underwent flexible ureterorenoscopy for removal of the proximal, middle, or distal ureteral single stone under general anaesthesia (GA group; n = 145) or spinal anaesthesia (SA group; n = 131) or epidural anaesthesia (EA group; n = 116) were reviewed retrospectively.Results The dilatation time for patients of GA group was fewer than those of SA (104.01 ± 12.77 sec/patient vs. 130.55 ± 22.53 sec/patient, p < .0001, q = 17.0350) and EA (104.01 ± 12.77 sec/patient vs. 147.03 ± 18.76 sec/patient, p < .0001, q = 26.7240) groups. The time to reach to stone for patients of GA group was fewer than those of SA (126.68 ± 12.59 sec/patient vs. 137.60 ± 17.84 sec/patient, p < .0001, q = 8.4510) and EA (126.68 ± 12.59 sec/patient vs. 149.44 ± 14.85 sec/patient, p < .0001, q = 17.0350) groups. The lithotripsy time (p = .359), operation time (p = .449), intraoperative complications (p = .058), and length of hospital stays (p = .057) of patients were same among groups. Visual analog scale pain scores of patients of the GA group found higher among groups. General anaesthesia caused nausea and vomiting.Conclusions This study suggests general anaesthesia for flexible ureterorenoscopy if there is no contraindication.KEY MESSAGEGeneral anaesthesia facilitates early dilatation of ureters and access to the stone.No strong correlation of the anaesthesia method of choice with lithotripsy time, operation time, intraoperative complications, stone-free conditions, and length of hospital stays.Epidural and spinal anaesthesia have advantages of fewer postoperative pain and better postoperative outcomes for flexible ureterorenoscopy.https://www.tandfonline.com/doi/10.1080/07853890.2021.1998596Anaesthesiadilatation timelithotripsy timestone free conditionsurgical complicationsureterorenoscopy |
| spellingShingle | Haoliang Cai Xiaohui Wu Xi Chen Wenting Chen Comparison of the effects of general, spinal and epidural anesthesia on ureter access and surgical outcomes during flexible ureterorenoscopy for transurethral single stone removal surgeries: a monocentric retrospective study Annals of Medicine Anaesthesia dilatation time lithotripsy time stone free condition surgical complications ureterorenoscopy |
| title | Comparison of the effects of general, spinal and epidural anesthesia on ureter access and surgical outcomes during flexible ureterorenoscopy for transurethral single stone removal surgeries: a monocentric retrospective study |
| title_full | Comparison of the effects of general, spinal and epidural anesthesia on ureter access and surgical outcomes during flexible ureterorenoscopy for transurethral single stone removal surgeries: a monocentric retrospective study |
| title_fullStr | Comparison of the effects of general, spinal and epidural anesthesia on ureter access and surgical outcomes during flexible ureterorenoscopy for transurethral single stone removal surgeries: a monocentric retrospective study |
| title_full_unstemmed | Comparison of the effects of general, spinal and epidural anesthesia on ureter access and surgical outcomes during flexible ureterorenoscopy for transurethral single stone removal surgeries: a monocentric retrospective study |
| title_short | Comparison of the effects of general, spinal and epidural anesthesia on ureter access and surgical outcomes during flexible ureterorenoscopy for transurethral single stone removal surgeries: a monocentric retrospective study |
| title_sort | comparison of the effects of general spinal and epidural anesthesia on ureter access and surgical outcomes during flexible ureterorenoscopy for transurethral single stone removal surgeries a monocentric retrospective study |
| topic | Anaesthesia dilatation time lithotripsy time stone free condition surgical complications ureterorenoscopy |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2021.1998596 |
| work_keys_str_mv | AT haoliangcai comparisonoftheeffectsofgeneralspinalandepiduralanesthesiaonureteraccessandsurgicaloutcomesduringflexibleureterorenoscopyfortransurethralsinglestoneremovalsurgeriesamonocentricretrospectivestudy AT xiaohuiwu comparisonoftheeffectsofgeneralspinalandepiduralanesthesiaonureteraccessandsurgicaloutcomesduringflexibleureterorenoscopyfortransurethralsinglestoneremovalsurgeriesamonocentricretrospectivestudy AT xichen comparisonoftheeffectsofgeneralspinalandepiduralanesthesiaonureteraccessandsurgicaloutcomesduringflexibleureterorenoscopyfortransurethralsinglestoneremovalsurgeriesamonocentricretrospectivestudy AT wentingchen comparisonoftheeffectsofgeneralspinalandepiduralanesthesiaonureteraccessandsurgicaloutcomesduringflexibleureterorenoscopyfortransurethralsinglestoneremovalsurgeriesamonocentricretrospectivestudy |