The Effect of Anesthesia Type on the Stability of the Surgical View on the Monitor in Retrograde Intrarenal Surgery for Renal Stone: A Prospective Observational Trial
Dongwook Won,
Sung Yong Cho,
Hyun-Joung No,
Jiwon Lee,
Jin-Young Hwang,
Tae Kyong Kim,
Jee-Eun Chang,
Hyerim Kim,
Jae-Hyun Choi,
Jung-Man Lee
Affiliations
Dongwook Won
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul 07061, Republic of Korea
Sung Yong Cho
Department of Urology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
Hyun-Joung No
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea
Jiwon Lee
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Republic of Korea
Jin-Young Hwang
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul 07061, Republic of Korea
Tae Kyong Kim
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul 07061, Republic of Korea
Jee-Eun Chang
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul 07061, Republic of Korea
Hyerim Kim
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul 07061, Republic of Korea
Jae-Hyun Choi
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
Jung-Man Lee
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul 07061, Republic of Korea
Background and Objectives: Retrograde intrarenal surgery (RIRS) is a minimally invasive technique for nephrolithiasis. RIRS is performed via a monitor screen displaying a magnified surgical site. Respiration can affect the stability of the surgical view during RIRS because the kidneys are close to the diaphragm. The purpose of this trial is to compare the effect of anesthesia type on the stability of the surgical view during RIRS between spinal anesthesia and general anesthesia. Materials and Methods: Patients were allocated to the general anesthesia group or spinal anesthesia group. During surgery, movement of the surgical field displayed on the monitor screen was graded by the first assistant on a 10-grade numeric rating scale (0–10). Next, it was also graded by the main surgeon. After surgery, we evaluated the discomfort with the anesthesia method for all patients. Results: Thirty-four patients were allocated to the general anesthesia group and 32 patients to the spinal anesthesia group. The average values of the two surgeons for surgical field oscillation grade showed vision on the monitor screen was more stable in the general anesthesia group than the spinal anesthesia group (3.3 ± 1.6 vs. 5.0 ± 1.6, p p = 0.114), even though more patients reported inconvenience with a grade of 3 or more in the spinal anesthesia group (8.8% vs. 28.1%, p = 0.042). Conclusions: In terms of the visualization of the surgical site, general anesthesia might provide a more stable surgical view during RIRS compared to spinal anesthesia without increasing inconvenience induced by the type of anesthesia.
