Ureteroscopy under spinal versus general anaesthesia: morbidity and stone clearance

ABSTRACT

To compare morbidity and stone clearance by ureteroscopy carried out under spinal anaesthesia with that carried out under general anaesthesia. Quasi-experimental study. The study was conducted at the Kidney Centre, Postgraduate Training Institute, Karachi, from September 2005 to December 2006. A total number of 60 patients were enrolled for the study. All patients underwent ureteroscopic procedure for a calculus disease, using a semi-rigid ureteroscope of 10 Fr. These patients were divided in 2 groups of 30 patients, receiving general or spinal anaesthesia. Operative time, stone clearance, hospital stay, intra- and postoperative complications and visual analogue score for pain were noted in each case. There were 30 patients each in both groups, with 73% males and 27% females in group A [general anaesthesia] and 93% males and 7% females in group B [spinal anaesthesia]. Mean age of the patients were 33.9 and 36.9 years in groups A and B respectively. The average stone size was 0.79 cm in group A and 1.14 cm in group B [p=0.001]. Duration of surgery was 41.4 +/- 1.29 minutes in group A and 30.5 +/- 2.13 minutes in group B [p=0.033]. Mean hospital stay was 21.6 and 18.1 hours in group A and B respectively [p= 0.073]. Mean visual analogue score for pain in group A was 3.1 and group B was 1.8. Ureteroscopy under spinal anaesthesia resulted in decreased length of operative time and shortened hospital stay in this series and did not carry any additional risk of major complications