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Chinese mini percutaneous nephrolithotomy for upper urinary calculi under local infiltration anesthesia

Percutaneous nephrolithotomy is generally performed under general or regional anesthesia; however, it is rarely performed under local infiltration anesthesia (LIA). This study aimed to assess the safety and effectiveness of Chinese mini percutaneous nephrolithotomy (MPCNL) for upper urinary calculi...

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Autores principales: Zhang, Zhao-Lin, Li, Fang-Zhi, Xie, Tian-Peng, Liu, Fo-Lin, Jiang, Bo, Yuan, Yuan-Hu, Xiao, Ri-Hai, Wang, Xiao-Ning
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545285/
https://www.ncbi.nlm.nih.gov/pubmed/37773861
http://dx.doi.org/10.1097/MD.0000000000035159
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author Zhang, Zhao-Lin
Li, Fang-Zhi
Xie, Tian-Peng
Liu, Fo-Lin
Jiang, Bo
Yuan, Yuan-Hu
Xiao, Ri-Hai
Wang, Xiao-Ning
author_facet Zhang, Zhao-Lin
Li, Fang-Zhi
Xie, Tian-Peng
Liu, Fo-Lin
Jiang, Bo
Yuan, Yuan-Hu
Xiao, Ri-Hai
Wang, Xiao-Ning
author_sort Zhang, Zhao-Lin
collection PubMed
description Percutaneous nephrolithotomy is generally performed under general or regional anesthesia; however, it is rarely performed under local infiltration anesthesia (LIA). This study aimed to assess the safety and effectiveness of Chinese mini percutaneous nephrolithotomy (MPCNL) for upper urinary calculi under LIA. A retrospective analysis of 52 patients with upper urinary stones who underwent MPCNL under LIA from April 2019 to May 2022 was performed. Pethidine and Phenergan were intramuscularly injected 30 minutes preoperatively. Oxybuprocaine hydrochloride gel was applied to the urethra for lubricating and mucosal anesthesia. Ropivacaine hydrochloride and lidocaine were injected into the whole percutaneous channel for local anesthesia. An 8/9.8F ureteroscope and an 18F vacuum-assisted access sheath were applied in MPCNL. All 52 patients tolerated procedures and underwent operations successfully; none of them converted the anesthesia method or required additional analgesia. The mean visual analogue scale scores intraoperatively and at 6 hours, 24 hours, and 48 hours after surgery were 3.25 ± 0.52, 3.13 ± 0.69, 2.25 ± 0.56, and 1.58 ± 0.50, respectively. The stone free rate was 84.6%. Complications were seen in 6 (11.5%) patients, including fever in 2 patients (Clavien I), renal colic in 1 patient (Clavien I), clinically insignificant bleeding in 2 patients (Clavien I), and urinary tract infection in 1 patient (Clavien II). No severe complications were observed in any patients. Chinese MPCNL under LIA was a feasible option and achieved good outcomes in appropriately selected patients, and it may become the routine procedure for general patients.
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spelling pubmed-105452852023-10-03 Chinese mini percutaneous nephrolithotomy for upper urinary calculi under local infiltration anesthesia Zhang, Zhao-Lin Li, Fang-Zhi Xie, Tian-Peng Liu, Fo-Lin Jiang, Bo Yuan, Yuan-Hu Xiao, Ri-Hai Wang, Xiao-Ning Medicine (Baltimore) 7300 Percutaneous nephrolithotomy is generally performed under general or regional anesthesia; however, it is rarely performed under local infiltration anesthesia (LIA). This study aimed to assess the safety and effectiveness of Chinese mini percutaneous nephrolithotomy (MPCNL) for upper urinary calculi under LIA. A retrospective analysis of 52 patients with upper urinary stones who underwent MPCNL under LIA from April 2019 to May 2022 was performed. Pethidine and Phenergan were intramuscularly injected 30 minutes preoperatively. Oxybuprocaine hydrochloride gel was applied to the urethra for lubricating and mucosal anesthesia. Ropivacaine hydrochloride and lidocaine were injected into the whole percutaneous channel for local anesthesia. An 8/9.8F ureteroscope and an 18F vacuum-assisted access sheath were applied in MPCNL. All 52 patients tolerated procedures and underwent operations successfully; none of them converted the anesthesia method or required additional analgesia. The mean visual analogue scale scores intraoperatively and at 6 hours, 24 hours, and 48 hours after surgery were 3.25 ± 0.52, 3.13 ± 0.69, 2.25 ± 0.56, and 1.58 ± 0.50, respectively. The stone free rate was 84.6%. Complications were seen in 6 (11.5%) patients, including fever in 2 patients (Clavien I), renal colic in 1 patient (Clavien I), clinically insignificant bleeding in 2 patients (Clavien I), and urinary tract infection in 1 patient (Clavien II). No severe complications were observed in any patients. Chinese MPCNL under LIA was a feasible option and achieved good outcomes in appropriately selected patients, and it may become the routine procedure for general patients. Lippincott Williams & Wilkins 2023-09-29 /pmc/articles/PMC10545285/ /pubmed/37773861 http://dx.doi.org/10.1097/MD.0000000000035159 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
spellingShingle 7300
Zhang, Zhao-Lin
Li, Fang-Zhi
Xie, Tian-Peng
Liu, Fo-Lin
Jiang, Bo
Yuan, Yuan-Hu
Xiao, Ri-Hai
Wang, Xiao-Ning
Chinese mini percutaneous nephrolithotomy for upper urinary calculi under local infiltration anesthesia
title Chinese mini percutaneous nephrolithotomy for upper urinary calculi under local infiltration anesthesia
title_full Chinese mini percutaneous nephrolithotomy for upper urinary calculi under local infiltration anesthesia
title_fullStr Chinese mini percutaneous nephrolithotomy for upper urinary calculi under local infiltration anesthesia
title_full_unstemmed Chinese mini percutaneous nephrolithotomy for upper urinary calculi under local infiltration anesthesia
title_short Chinese mini percutaneous nephrolithotomy for upper urinary calculi under local infiltration anesthesia
title_sort chinese mini percutaneous nephrolithotomy for upper urinary calculi under local infiltration anesthesia
topic 7300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545285/
https://www.ncbi.nlm.nih.gov/pubmed/37773861
http://dx.doi.org/10.1097/MD.0000000000035159
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