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 .
Combined general and epidural anesthesia with ropivacaine for renal transplantation.
AIM To evaluate the effectiveness and safety of epidural ropivacaine anesthesia in association with light general anesthesia during renal transplantation and compare epidural and endovenous analgesia techniques for postoperative pain control . METHODS EXPERIMENTAL DESIGN prospect i ve r and omized study . SETTING Organ Transplantation Center , Department of Surgery , " Tor Vergata " University of Rome , St. Eugenio Hospital , Rome . PATIENTS 25 patients affected by chronic renal failure were enrolled in this study . Thirteen constituted the  combined epidural-general anesthesia group ( EPI-GEN ) , mean age 40.15+/-9.81 years ; while the others constituted the general anesthesia group ( GEN ) , mean age 46.75+/-7.45 years . Operation : cadaveric renal transplantation . Group EPI-GEN : epidural anesthesia performed with 12 - 15 ml of a ropivacaine 0.75 % and fentanyl 5 microg/ml solution followed by light intravenous or inhalatory general anesthesia and postoperative epidural analgesia with ropivacaine 0.2 % and fentanyl 2 mg/ml . Group GEN : inhalatory or intravenous general anesthesia and intravenous tramadol postoperative analgesia . MEASUREMENTS hemo-dynamics , renal function , arterial blood gases analysis , acid-base balance and postoperative pain data was collected and examined . RESULTS Postoperative epidural analgesia result ed significantly more effective than intravenous tramadol . PaO(2)/FiO(2 ) ratio was significantly higher in group EPI-GEN patients both on awakening and throughout postoperative observation . Hemodynamics and renal function did not appear to differ significantly . CONCLUSION Combined epidural-general anesthesia is as valid a technique as any for renal transplantation ; however postoperative epidural ropivacaine analgesia result ed more effective than intravenous tramadol . Respiratory function appeared less affected , facilitating a fast and uncomplicated postoperative recovery
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 .