Comparison of anesthesia techniques in ureteroscopic lithotripsy with holmium laser for kidney stones: A computed tomography-guided study

This study was intended to observe and compare the safety and efficacy of general intravenous anesthesia with laryngeal mask airway (LMA) or combined spinal epidural anesthesia (CSEA) when performing ureteroscopic lithotripsy using the holmium laser for kidney stones. From September 2017 to May 2022, a total of 106 patients with kidney stones confirmed by computed tomography (CT) scans participated in the study. Patients undergo general intravenous anesthesia using a laryngeal mask airway (LMA) or combined spinal-epidural anesthesia (CSEA) prior to ureteroscopic lithotripsy using a holmium laser. Ureteroscopic holmium laser lithotripsy was then performed. The changes in mean arterial pressure (MAP) and heart rate (HR) 10 min before surgery and during surgery (10 min after the start of surgery) as well as the surgery time were recorded and compared between the two groups. In addition, side effects and difficulty of surgery, lithotripsy success rates, and patient comfort were recorded and compared. The two groups had no significant difference in MAP and HR before surgery. After anesthesia and during the operation, MAP and HR decreased significantly in the CSEA group (P < 0.05), which required quicker fluid infusion and Use of vasopressors; however, the LMA group had no significant changes, with no apparent physical movement, reasonable breathing control, and easy lithotripsy. During the surgical operation, the patient's discomfort response rate was lower in the LMA group than in the CSEA group. Compared with CSEA, LMA is a more comfortable and safe surgical anesthesia method for treating kidney stones with flexible ureteroscopic holmium laser lithotripsy.