renal stone. Calculus of kidney
Conditions
Interventions
Intervention 1: In the intervention group in which PCNL will be performed under spinal anesthesia, while the patient is positioned in the ipsilateral decubitus, using a 25 gauge quinke needle 0.25 mg/
Treatment - Surgery
In the intervention group in which PCNL will be performed under spinal anesthesia, while the patient is positioned in the ipsilateral decubitus, using a 25 gauge quinke needle 0.25 mg/kg of bupivacain
In control group in which PCNL will be performed under general anesthesia, anesthesia is induced with 2mg/kg of propofol plus 0.5 mg/kg of atracurium, then is continued with with 0.1 mg/kg.min of prop
Sponsors
Urology and nephrology research center
Eligibility
Sex/Gender
All
Age
16 Years to 70 Years
Inclusion criteria
Inclusion criteria: Inclusion criteria: all the patients older than 16 years who present with pelvis and/or calyceal stone and are candidate for PCNL surgery. Exclusion criteria: 1- lack of consent for either of general or spinal anesthesia; 2- complete staghorn stone defined as pelvic stone concomitant with at least three calyces stones' 3- single kidney or single functional kidney ptients; 4- patients with a history of ipsilateral renal surgery; 5- patients with high serum creatinin levels ( higher than 2.5) due to prerenal, renal or postrenal azotemia; 6- congenital anatomic abnormality in the kidney undergoing surgery (malrotation, pelvic kidney, horse-shoe kidney); 7- patients who are suitable only for one type of anesthesia due to medical conditions, body habitus (pinal deformity, dificult-to-intubate larynx), etc; 8- any history of hypersensitivity to remifentanyl, propofol, atracurium, spinal anesthesia material; 9- opioid or alcohol addiction and 10- BMI higher than 30
Exclusion criteria
Exclusion criteria:
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Stone clearance. Timepoint: 24 hours after intervention. Method of measurement: Abdominal X-ray.;Transfusion rate. Timepoint: From start of surgery untill discharge. Method of measurement: Number of pack cells transfused.;Opioid requirement. Timepoint: Opioid required during the first 48 hours after procedure. Method of measurement: Infusion pump contolled by patient.;Volume of urinary leakage. Timepoint: During the time of hospitalization. Method of measurement: Amount of urinary leakage through nephrostomy tract.;Visceral injury. Timepoint: During the procedure. Method of measurement: According to the sign and symptoms of patient.;Hemoglobin changes. Timepoint: Before and 6 hours after procedure. Method of measurement: Mg/dL according to the lab data.;Serum creatinin changes. Timepoint: Before and 6 hours after procedure. Method of measurement: Mg/dL accoding to the lab data. | — |
Secondary
| Measure | Time frame |
|---|---|
| Fluoroscopy time. Timepoint: At the end of procedure. Method of measurement: Time of exposure to X-ray.;Hospitalization time. Timepoint: From admission to discharge from hospital. Method of measurement: Days of hospitalization according to hospital file. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactDr Hossein Kilani
Shahid Labbafinejad Medical Center
Outcome results
None listed