Objective
To evaluate the possibility of performing ureterorenoscopy and insitu lithotripsy for
upper ureteric and solitary pelvic calculi under spinal anesthesia.
Patients and Methods
This descriptive study was conducted at POF Hospital, Wah Cant from June 2008 to
December 2008. A total of 125 ASA-I patients, 75 male and 50 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 25G spinal needle at L3-4 interspace
using 0.75% bupivacaine 15 mg and underwent ureterorenoscopy or insitu lithotripsy.
Intraoperative and postoperative complications including hypotension, vomiting, 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 3 patients achieved adequate anesthesia for the procedures.
Ten patients had hypotension and 4 had bradycardia intraoperatively. Vomiting
occurred in 3 patients and PDPH in two. 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 hours.
2
Conclusions
Spinal anesthesia can be safely used for insitu lithotripsy of upper ureteric calculi and
solitary renal pelvic calculi with decreased hospital stay and minimal post operative
complications. (Rawal Med J 2009;34: ).
Key words: Spinal anesthesia, ureteric calculi, ureterorenoscopy, insitu lithotripsy.
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