Post Operative Pain Clinical Trial
Official title:
Comparative Evaluation of General Anesthesia (SEA) Using 0.5% Bupivacaine and Segmental Epidural Anesthesia (GA) for Percutaneous Nephro Lithotomy - A Retrospective Analysis
Management of nephrolithiasis has been revolutionized by the advent of shock-wave
lithotripsy (ESWL) and percutaneous nephrolithotomy (PCNL). PCNL is a minimally invasive
endoscopic technique and is used for the fragmentation and removal of stones of size more
than 20 to 30 mm, staghorn stones or multiple stones resistant to ESWL. Anaesthesia for PCNL
is a challenge because of the disease, surgical procedure, positioning, hypothermia,and the
possibility of fluid absorption, dilutional anaemia and blood loss. General anaesthesia is
the gold standard for this surgery.The advent of new drugs has refined the technique of
general anaesthesia. However there are several issues related to prone position still to be
addressed like accidental extubation and difficult reintubation, nerve injuries and post
operative respiratory complications.
Combined spinal epidural(CSE) and only epidural anaesthesia (EA) is a well established
technique of anaesthesia for upper abdomen and lower thoracic surgeries. It use has also
been reported in PCNL surgeries.Segmental epidural can selectively blocks pain fibres from
the surgical site. This not only allows to limit the dose of the local anaesthetics, but
also limit motor and sympathetic blockade. Selective sympathetic block is associated with
respiratory, cardiac, gastrointestinal and metabolic benefits. This formed the basis of our
current study. In the present study the investigators aimed to evaluate the efficacy of
segmental epidural for PCNL and compared it with standard technique i.e. GA.
To evaluate efficacy the investigators compared intraoperative haemodynamics, surgical clearance of stones, post operative pain, surgeon's and Patient's satisfaction scores and postoperative complications and side effects in 60 ASA I and II patients undergoing PCNL surgery who received either General anesthesia or Segmental epidural Anesthesia. ;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Screening
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