At the moment , the evidence available can not prove that neuraxial anesthesia is more effective and safer than general anesthesia for urological surgery .
There were insufficient data to pool the results relating to mortality , stroke , myocardial infa rct ion , length of hospitalization , quality of life , degree of satisfaction , postoperative cognitive dysfunction and blood transfusion requirements
CONTEXT AND OBJECTIVE Choosing the best anesthetic technique for urological surgery with the aim of mortality reduction remains controversial .
The objective here was to compare the effectiveness and safety of neuraxial anesthesia versus general anesthesia for urological surgery .
Spinal-epidural anesthesia versus general anesthesia in the management of percutaneous nephrolithotripsy.
OBJECTIVE To compare the efficacy between combined spinal-epidural block and general anesthesia in patients undergoing percutaneous nephrolithotripsy ( PNL ) . METHODS A total of 180 patients undergoing PNL were r and omly allocated to receive spinal-epidural anesthesia plus intravenous patient-controlled anesthesia with tramadol or general anesthesia ( propofol induction , maintenance with sevoflurane ) plus intravenous patient-controlled anesthesia with tramadol ( G group ) . Hemodynamic changes , postanesthesia care unit ( PACU ) discharge times , times to home readiness , side effects , patient and endoscopist satisfaction , postoperative pain ( scored from 0 to 10 on a visual analog scale ) , and analgesic medication were recorded . RESULTS Rates of hypotension ( p = 0.06 ) and bradycardia ( p = 0.14 ) did not differ between the groups . Compared with the G group , duration of PACU and the time to home readiness ( p = 0.001 for each ) were shorter in the spinal-epidural group . The incidence of nausea was higher in the G group ( p = 0.001 ) ; vomiting and pruritus rates were similar between groups . No patient had respiratory depression . The spinal-epidural group had better patient satisfaction ( p = 0.001 ) and lower pain scores ( p = 0.001 ) . The G group required more diclofenac during the first 48 h ( p = 0.001 ) . CONCLUSIONS In patients undergoing PNL , spinal-epidural anesthesia and analgesia gave greater patient satisfaction , shorter times for PACU and home readiness , and less postoperative pain .  Spinal-epidural anesthesia is an attractive alternative to general anesthesia in these patients
At the moment , the evidence available can not prove that neuraxial anesthesia is more effective and safer than general anesthesia for urological surgery .
There were insufficient data to pool the results relating to mortality , stroke , myocardial infa rct ion , length of hospitalization , quality of life , degree of satisfaction , postoperative cognitive dysfunction and blood transfusion requirements
CONTEXT AND OBJECTIVE Choosing the best anesthetic technique for urological surgery with the aim of mortality reduction remains controversial .
The objective here was to compare the effectiveness and safety of neuraxial anesthesia versus general anesthesia for urological surgery .