Regional Anesthesia for Ureteroscopy and Lithotripsy for Upper Ureteric and Solitary Pelvic Calculi?An Experience at IGGGH & PGI Pondicherry
Author(s): Hemanatha Kannan M, Rajesh Kumar* and Sudhakar K
Abstract
Objective: To estimate the limitations of regional anesthesia in ureterorenoscopy and lithotripsy for upper ureteric and solitary pelvic calculi at Indira Gandhi Government General Hospital and Post Graduate Institute (IGGGH & PGI), Puducherry. Patients and Methods: This prospective study was conducted at IGGGH and PGI, Pondicherry from December 2019 to September 2021. A total of 140 ASA-I patients, 85 male and 55 female, age ranging from 18 to 70 years, having upper ureteric or solitary pelvic calculi, were enrolled for the study. All received spinal anesthesia with 26G Quincke spinal needle at L3-4 interspace using 0.5% of (15mg) bupivacaine 3 ml and underwent ureterorenoscopy or insitu lithotripsy. Intraoperative and postoperative complications including hypotension, vomiting, plural effusion, pain on visual analgesia scale and duration of hospital stay were noted. Results: All patients had a successful motor block of hip and knee and sensory block up to T8. All with the exception of 4 patients achieved adequate anesthesia for the procedures. 4 patients had hypotension and 5 had bradycardia intraoperative. Vomiting occurred in 3 patients and PDPH in 3. All patients were shifted to ward 4 hours post operatively after confirmation of complete reversal of block and hemodynamic stability. The average stay of all patients in the hospital was 36-48 hours. Conclusions: Regional anesthesia can be safely used for lithotripsy of upper ureteric calculi and solitary renal pelvic calculi with decreased hospital stay and minimal post-operative and intra operative complications.