Comparison of Spinal and General Anesthesia Outcomes in Geriatric Patients Undergoing Retrograde Intrarenal Surgery

Objective: This study aims to investigate the feasibility of spinal anesthesia (SA) in retrograde intrarenal surgery (RIRS) among patients aged over 65 years, and to compare the effectiveness of spinal and general anesthesia (GA) techniques on postoperative pain. Material and Methods: A retrospective analysis was conducted on 281 patients who underwent RIRS. Patients were divided into two groups: those who received SA (Group 1) and those who received GA (Group 2). Perioperative and postoperative outcomes of RIRS were compared between the groups. Additionally, postoperative pain levels in both the early and late periods were assessed using the Visual Analog Scale (VAS). Results: Group 1, which received SA, consisted of 166 patients, while Group 2, which received GA, included 115 patients. There was no statistically significant difference between the two groups in the demographic data and stone characteristics. The complication rates, classified according to the modified Clavien-Dindo system, were comparable between the two anesthesia techniques. The mean early postoperative VAS score was 2.26 ± 0.99 in Group 1 and 3.58 ± 1.13 in Group 2, with the difference being statistically significant (p < 0.001). However, there was no statistically significant difference in late postoperative VAS scores between the groups (p = 0.362). Postoperative analgesic requirement was observed in 10.24% of patients in Group 1, compared to 27.82% in Group 2, and this difference was statistically significant (p < 0.001). Conclusion: SA may be a viable alternative to GA in geriatric patients undergoing RIRS, as it provides favorable outcomes in postoperative pain control and may protect patients from certain potential morbidities associated with GA.