COMPARISON OF TWO KINDS OF ANESTHESIOLOGY IN URETEROSCOPIC LITHOTRIPSY WITH THE HOLMIUM LASER FOR KIDNEY STONE

Abstract

Objective: This study was intended to observe and compare the safety and efficacy of general intravenous anesthesia with laryngeal mask airway (LMA) or combined spinal epidural anesthesia (CSEA) when performing ureteroscopic lithotripsy using the holmium laser for kidney stone. Methods: From September 2017 and May 2022, a total of 106 patients who were diagnosed with kidney stone received general intravenous anesthesia with LMA or CSEA before going ureteroscopic lithotripsy using the holmium laser. In preoperative 10 min and intraoperative (surgery has begun 10 min), the changes in mean arterial pressure (MAP) and heart rate (HR) as well as the time of surgery were noted and compared in the two groups. In addition, operative side effects and difficulty, rate of success of lithotripsy, and patients’ sense of comfort were also noted and compared. Results: There was no significant difference in MAP and HR between the two groups before surgery. After anesthesia and during the operation, MAP and HR decreased significantly in the CSEA group (P<0.05), which required quicker fluid infusion and use of vasopressors; however, the LMA group had no significant changes, with no obvious physical movement, good breathing control, and easy lithotripsy. In the course of the surgical operation, the patient's no discomfort response rate was in the LMA group lower than those in the CSEA group. Conclusion: Compared with CSEA, LMA is a more comfortable and safe anesthesia method that is more conducive to surgical operation in the treatment of kidney stone with flexible ureteroscopic holmium laser lithotripsy.