Comparison of Anesthesia Strategies in Percutaneous Nephrolithotomy

Objective: Percutaneous nephrolithotomy (PCNL) is an effective and reliable method for the surgical treatment of kidney stones and is frequently performed under general anesthesia (GA). However, in recent years, the use of regional anesthesia (RA) techniques (spinal, epidural, combined spinal-epidural) as alternatives to general anesthesia has been increasing. In this study, we aimed to compare the effectiveness and reliability of the anesthesia methods used in PCNL. Methods: This retrospective, single-center study included 166 patients who underwent PCNL at Basaksehir Cam and Sakura City Hospital between February 2023 and 2024. Results: No statistically significant difference was found between the two groups in terms of gender, ASA score, age, body mass index, stone type, stone location, stone volume, anesthesia duration, surgery duration, hemoglobin decrease, need for blood replacement, need for postoperative intensive care follow-up, length of hospitalization, bleeding requiring transfusion, causes of increased acute phase reactants, and pulmonary complications such as desaturation and diaphragmatic damage. Conclusion: In PCNL surgery, GA and RA have similar rates in terms of length of hospital stay, anesthesia and surgery duration, need for perioperative blood replacement, increase in postoperative acute phase reactants, and respiratory complications. Both types of anesthesia have advantages and disadvantages. Therefore, it is recommended that the decision to choose between GA and RA should be determined by a multidisciplinary approach.