Effects of anesthesia methods applied in ureter upper end stone operations on early postoperative quality of life

Fatih Suslu; Mehmet Ali Turgut; Enes Celik; Ilksen Donmez; Fikret Salik

doi:10.5281/zenodo.11306315

Authors

Fatih Suslu Batman Traning and Research Hospital, Operating Theatre Anesthesia Department, Batman, Turkey https://orcid.org/0000-0002-2347-7149
Mehmet Ali Turgut Mardin Traning and Research Hospital, Operating Theatre Anesthesia Department, Mardin, Turkey https://orcid.org/0000-0002-2622-6951
Enes Celik Mardin Artuklu University Medical School Department of Anesthesiology and Reanimation, Mardin, Turkey https://orcid.org/0000-0002-5546-4924
Ilksen Donmez Istanbul Beyoglu Eye Traning and Research Hospital, Operating Theatre Anesthesia Department, Istanbul, Turkey https://orcid.org/0000-0001-8581-6583
Fikret Salik Dicle University Medical School Department of Anesthesiology and Reanimation, Diyarbakır, Turkey https://orcid.org/0000-0002-7715-3545

DOI:

https://doi.org/10.5281/zenodo.11306315

Keywords:

Anesthesia methods, spinal anesthesia, ureterorenoscopy

Abstract

Objective: Urinary system Stone disease (urolithiasis) is a disease that changes and is increasingly prevalent depending on many factors, and nowadays, monitoring, medical removal therapy, shock wave lithotripsy (SWL), ureterorenoscopy (URS), laparoscopic surgeries and open surgery to treat proximal ureter stones. In our study, we aimed to investigate the comparison of intraoperative tolerance and early postoperative quality of life levels of general anesthesia, spinal anesthesia and spinal anesthesia with adjuvant agent in patients to be operated for upper ureteral calculi.

Materials and methods: This study was conducted prospectively. In our study, we aimed to investigate the comparison of intraoperative tolerance and early postoperative life quality levels of patients with general anesthesia, spinal anesthesia and adjuvant spinal anesthesia in patients who will be operated on for upper ureteral stones, and for this purpose, 75 patients who were operated on and met the inclusion criteria were recruited. In our study, patients who were operated under general anesthesia were named as group 1, those who were operated under spinal anesthesia using only bupivacaine, group 2, and those who were operated using bupivacaine + fentanyl were named as group 3. Each group consisted of 25 patients. Statistical analyses were performed using SPPS v.20.0.

Results: It was observed that the duration of anesthesia, operation time, VAS pain scale, intraoperative heart rate change and intraoperative diastolic blood pressure did not show statistically significant difference between the groups. İt was determined that intraoperative systolic blood pressure was higher inboth groups that underwent spinal anesthesia compared to the group that was applied general anesthesia, and the spo2 level was lower.

Conclusions: In this study, in which we evaluated spinal anesthesia as an alternative to general anesthesia, we found that spinal anesthesia is also safe and effective in proximal ureter stone operations. Therefore we think that spinal anesthesia should be preferred more frequently due to the lower risk of postoperative nausea and vomiting, postoperative analgesia, early mobilization and early nutrition compared to general anesthesia.

References

Sancak EB, Kılınç MF, Yücebaş SC. Evaluation with decision trees of efficacy and safety of semirigid ureteroscopy in thetreatment of proximal ureteral calculi. Urol Int. 2017;99(3):320-5.

Reis Santos JM. Ureteroscopy from the recentpastto the near future. Urolithiasis. 2018;46(1):31-7.

Coll DM, Varanelli MJ, Smith RC. Relationship of spontaneous passage of ureteral calculitostone size and location as revealed by unenhancedhelical CT. AJR Am J Roentgenol. 2002;178(1):101-3.

Türk C, Neisius A, Petrik A, Seitz C, Thomas K. Guidelines on urolithiasis. Arnhem: European Association of Urology; 2018. Available at http://www.uroweb.org/gls/pdf.

Litwin MS, Saigal CS. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, PublicHealth Service, US Department of Healthand Human Services. Urologic Diseases in America; Washington, DC: 2012. Table 14-47: Economic impact of urologic disease; p. 486. NIH publication 12-7865.

Antonelli JA, Maalouf NM, Pearle MS, Lotan Y. Use of the National Health and Nutrition Examination Survey to calculate the impact of obesity and diabetes on cost and prevalence of urolithiasis in 2030. Eur Urol. 2014;66(4):724-9.

Kılınç MF, Doluoğlu ÖG, Karakan T, Dalkılıç A, Sönmez NC, Yücetürk CN, et al. The effect of ureteroscope size in the treatment of ureteral stone: 15-year experience of an endoscopist. Turk J Urol. 2016;42(2):64-9.

Hosking DH, Bard RJ. Ureteroscopy with intravenous sedation for treatment of distal ureteral calculi: a safe and effective alternative to shockwave lithotripsy. J Urol. 1996;156(3):899-901.

Chan PS, Fenn J, Li AK. Transurethral ureterorenoscopic lithotripsy and retrieval of uretericcalculi under local anaesthesia and sedation. Br J Urol 1990;65(2):141-3.

Katafigiotis I, Sabler IM, Heifetz EM, Isid A, Sfoungaristos S, Lorber A, et al. Factors Predicting Operating Room Time in Ureteroscopy and Ureterorenoscopy. Curr Urol. 2019;12(4):195-200.

Barut O, Resim S. Comparison Of Different Anesthesia Methods In Patients With Percutaneous Nephrolithotomy. The New J Urol. 2020;15:1-6.

Bartels K, Frendl G, Sprung J, Weingarten TN, Subramaniam B, Martinez Ruiz R, et al. Postoperative pulmonary complications with adjuvant regional anesthesia versus general anesthesia alone: a sub-analysis of the Perioperative Research Network study. BMC Anesthesiol. 2022;22(1):136.

Oztekin U, Caniklioglu M, Atac F, Kantekin CU, Gurel A, Isikay L. Comparison of Safety and Efficiency of General, Spinal and Epidural Anesthesia Methods Used for the Endoscopic Surgical Treatment of Ureteral Stones: Which One is Better To Access The Ureter and Reach The Stone? Urol J. 2020;17(3):237-42.

Cai H, Wu X, Chen X, Chen W. 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. Ann Med. 2021;53(1):2110-9.

Bosio A, Alessandria E, Vitiello F, Vercelli E, Agosti S, Gontero P. Flexible Ureterorenoscopy under Spinal Anesthesia: Focus on Technique, Results, Complications, and Patients' Satisfaction from a Large Series. Urol Int 2022;106(5):455-60.

Sahan M, Sarilar O, Akbulut MF, Demir E, Savun M, Sen O, et al. Flexible ureterorenoscopy and laser lithotripsy with regional anesthesia vs general anesthesia: A prospective randomized study. Int Braz J Urol. 2020;46(6):1010-8.

Billard V, Moulla F, Bourgain JL, Megnigbeto A, Stanski DR. Hemodynamic response to induction and intubation. Propofol/fentanyl interaction. Anesthesiology 1994;81(6):1384-93.