A Comparative Study of Epidural Anesthesia with Dexmedetomidine Infusion versus General Anesthesia for Percutaneous Nephrolithotomy
There has been considerable debate regarding the ideal anaesthetic technique for Percutaneous Nephrolithotomy (PCNL). PCNL is usually performed under general anaesthesia (GA) in prone position. The prone position under GA is associated with various complications. To address these complications, our...
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| Veröffentlicht in: | Anesthesia Essays & Researches 2021-07, Vol.15 (3), p.306-311 |
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| creator | Turki, Sonali Mir, Shafat Ahmad Sofi, Khalid P Khan, Nadeem Khawaja, Rouf Wani, Mohammad S |
| description | There has been considerable debate regarding the ideal anaesthetic technique for Percutaneous Nephrolithotomy (PCNL). PCNL is usually performed under general anaesthesia (GA) in prone position. The prone position under GA is associated with various complications. To address these complications, our study was carried out to determine whether epidural anaesthesia [EA] with dexmedetomidine sedation can be a better alternative to GA for PCNL.
To compare the efficacy and feasibility of performing PCNL under EA in combination with dexmedetomidine infusion.
Out of 225 patients observed in this study, 115 patients (group A) underwent PCNL under EA with dexmedetomidine infusion and 110 patients (group B) underwent PCNL under GA.
Mean time to the first dose of rescue analgesia was significantly increased in Epidural group (328.17 ± 63.74) compared to GA group (72.09 min, p < .0001) and the mean Visual analog scale [VAS] scores were significantly lower in epidural compared to GA group at different time intervals during the first 24 h after surgery (p |
| doi_str_mv | 10.4103/aer.aer_124_21 |
| format | Article |
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To compare the efficacy and feasibility of performing PCNL under EA in combination with dexmedetomidine infusion.
Out of 225 patients observed in this study, 115 patients (group A) underwent PCNL under EA with dexmedetomidine infusion and 110 patients (group B) underwent PCNL under GA.
Mean time to the first dose of rescue analgesia was significantly increased in Epidural group (328.17 ± 63.74) compared to GA group (72.09 min, p < .0001) and the mean Visual analog scale [VAS] scores were significantly lower in epidural compared to GA group at different time intervals during the first 24 h after surgery (p<0.05). Patients in epidural group had significantly less post-operative nausea, vomiting (6.1 % vs 13.6 %), and significantly less shivering (12.2% vs 33.6%). Mean patient satisfaction score in epidural group was significantly higher (8.75 ± 1.29 vs 8.14 ± 1.39, p=0.001); however, the mean surgeon satisfaction score was comparable among the two groups (8.76 ± 1.39 in Group A and 8.61 ± 1.35 in Group B, p=0.421).
Our study shows that EA is an equally effective alternative to GA for PCNL, with more patient satisfaction, less postoperative pain, early ambulation and postoperative recovery, less systemic analgesic requirements and less adverse effects.</description><identifier>ISSN: 0259-1162</identifier><identifier>EISSN: 2229-7685</identifier><identifier>DOI: 10.4103/aer.aer_124_21</identifier><identifier>PMID: 35320957</identifier><language>eng</language><publisher>India: Medknow Publications and Media Pvt. Ltd</publisher><subject>Anesthesia ; Comparative analysis ; Dexmedetomidine ; Original</subject><ispartof>Anesthesia Essays & Researches, 2021-07, Vol.15 (3), p.306-311</ispartof><rights>Copyright: © 2022 Anesthesia: Essays and Researches.</rights><rights>COPYRIGHT 2021 Medknow Publications and Media Pvt. Ltd.</rights><rights>Copyright: © 2022 Anesthesia: Essays and Researches 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c316t-cbb55ed257ebddd2e8a177e73176acf856bf8121184d89acd6657be46a8a533b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936872/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936872/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27922,27923,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35320957$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Turki, Sonali</creatorcontrib><creatorcontrib>Mir, Shafat Ahmad</creatorcontrib><creatorcontrib>Sofi, Khalid P</creatorcontrib><creatorcontrib>Khan, Nadeem</creatorcontrib><creatorcontrib>Khawaja, Rouf</creatorcontrib><creatorcontrib>Wani, Mohammad S</creatorcontrib><title>A Comparative Study of Epidural Anesthesia with Dexmedetomidine Infusion versus General Anesthesia for Percutaneous Nephrolithotomy</title><title>Anesthesia Essays & Researches</title><addtitle>Anesth Essays Res</addtitle><description>There has been considerable debate regarding the ideal anaesthetic technique for Percutaneous Nephrolithotomy (PCNL). PCNL is usually performed under general anaesthesia (GA) in prone position. The prone position under GA is associated with various complications. To address these complications, our study was carried out to determine whether epidural anaesthesia [EA] with dexmedetomidine sedation can be a better alternative to GA for PCNL.
To compare the efficacy and feasibility of performing PCNL under EA in combination with dexmedetomidine infusion.
Out of 225 patients observed in this study, 115 patients (group A) underwent PCNL under EA with dexmedetomidine infusion and 110 patients (group B) underwent PCNL under GA.
Mean time to the first dose of rescue analgesia was significantly increased in Epidural group (328.17 ± 63.74) compared to GA group (72.09 min, p < .0001) and the mean Visual analog scale [VAS] scores were significantly lower in epidural compared to GA group at different time intervals during the first 24 h after surgery (p<0.05). Patients in epidural group had significantly less post-operative nausea, vomiting (6.1 % vs 13.6 %), and significantly less shivering (12.2% vs 33.6%). Mean patient satisfaction score in epidural group was significantly higher (8.75 ± 1.29 vs 8.14 ± 1.39, p=0.001); however, the mean surgeon satisfaction score was comparable among the two groups (8.76 ± 1.39 in Group A and 8.61 ± 1.35 in Group B, p=0.421).
Our study shows that EA is an equally effective alternative to GA for PCNL, with more patient satisfaction, less postoperative pain, early ambulation and postoperative recovery, less systemic analgesic requirements and less adverse effects.</description><subject>Anesthesia</subject><subject>Comparative analysis</subject><subject>Dexmedetomidine</subject><subject>Original</subject><issn>0259-1162</issn><issn>2229-7685</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNptksFrHCEUxqW0NMs21x6L0Esvsx11dJxLYdkmaSAkgbZncfRNVpjRqc5su-f-43HZNG1KEJGnv_fxPvwQekvKVUVK9lFDXOWtCK0UJS_QglLaFLWQ_CValJQ3BSGCnqDTlFyba0JFQ6rX6IRxRsuG1wv0e403YRh11JPbAf46zXaPQ4fPRmfnqHu89pCmLSSn8U83bfFn-DWAhSkMzjoP-NJ3c3LB4x3ENCd8AR7-6-tCxLcQzTxpDyEz1zBuY-izXMg6-zfoVaf7BKcP5xJ9Pz_7tvlSXN1cXG7WV4VhREyFaVvOwVJeQ2utpSA1qWuoGamFNp3kou0koYTIyspGGysEr1uohJaaM9ayJfp01B3nNnsw4Kc8qRqjG3Tcq6Cdevri3VbdhZ2SDROyplngw4NADD_m7E8NLhno-6MvRUVFpZQi_80SvT-id7oH5XwXsqI54Gotmko0VPIDtXqGysvC4Ezw0Ll8_1yDiSGlCN3j9KRUh0yoQx7-ZiI3vPvX8yP-JwHsHpmDt2E</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Turki, Sonali</creator><creator>Mir, Shafat Ahmad</creator><creator>Sofi, Khalid P</creator><creator>Khan, Nadeem</creator><creator>Khawaja, Rouf</creator><creator>Wani, Mohammad S</creator><general>Medknow Publications and Media Pvt. Ltd</general><general>Wolters Kluwer - Medknow</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210701</creationdate><title>A Comparative Study of Epidural Anesthesia with Dexmedetomidine Infusion versus General Anesthesia for Percutaneous Nephrolithotomy</title><author>Turki, Sonali ; Mir, Shafat Ahmad ; Sofi, Khalid P ; Khan, Nadeem ; Khawaja, Rouf ; Wani, Mohammad S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c316t-cbb55ed257ebddd2e8a177e73176acf856bf8121184d89acd6657be46a8a533b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anesthesia</topic><topic>Comparative analysis</topic><topic>Dexmedetomidine</topic><topic>Original</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Turki, Sonali</creatorcontrib><creatorcontrib>Mir, Shafat Ahmad</creatorcontrib><creatorcontrib>Sofi, Khalid P</creatorcontrib><creatorcontrib>Khan, Nadeem</creatorcontrib><creatorcontrib>Khawaja, Rouf</creatorcontrib><creatorcontrib>Wani, Mohammad S</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Anesthesia Essays & Researches</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Turki, Sonali</au><au>Mir, Shafat Ahmad</au><au>Sofi, Khalid P</au><au>Khan, Nadeem</au><au>Khawaja, Rouf</au><au>Wani, Mohammad S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Comparative Study of Epidural Anesthesia with Dexmedetomidine Infusion versus General Anesthesia for Percutaneous Nephrolithotomy</atitle><jtitle>Anesthesia Essays & Researches</jtitle><addtitle>Anesth Essays Res</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>15</volume><issue>3</issue><spage>306</spage><epage>311</epage><pages>306-311</pages><issn>0259-1162</issn><eissn>2229-7685</eissn><abstract>There has been considerable debate regarding the ideal anaesthetic technique for Percutaneous Nephrolithotomy (PCNL). PCNL is usually performed under general anaesthesia (GA) in prone position. The prone position under GA is associated with various complications. To address these complications, our study was carried out to determine whether epidural anaesthesia [EA] with dexmedetomidine sedation can be a better alternative to GA for PCNL.
To compare the efficacy and feasibility of performing PCNL under EA in combination with dexmedetomidine infusion.
Out of 225 patients observed in this study, 115 patients (group A) underwent PCNL under EA with dexmedetomidine infusion and 110 patients (group B) underwent PCNL under GA.
Mean time to the first dose of rescue analgesia was significantly increased in Epidural group (328.17 ± 63.74) compared to GA group (72.09 min, p < .0001) and the mean Visual analog scale [VAS] scores were significantly lower in epidural compared to GA group at different time intervals during the first 24 h after surgery (p<0.05). Patients in epidural group had significantly less post-operative nausea, vomiting (6.1 % vs 13.6 %), and significantly less shivering (12.2% vs 33.6%). Mean patient satisfaction score in epidural group was significantly higher (8.75 ± 1.29 vs 8.14 ± 1.39, p=0.001); however, the mean surgeon satisfaction score was comparable among the two groups (8.76 ± 1.39 in Group A and 8.61 ± 1.35 in Group B, p=0.421).
Our study shows that EA is an equally effective alternative to GA for PCNL, with more patient satisfaction, less postoperative pain, early ambulation and postoperative recovery, less systemic analgesic requirements and less adverse effects.</abstract><cop>India</cop><pub>Medknow Publications and Media Pvt. Ltd</pub><pmid>35320957</pmid><doi>10.4103/aer.aer_124_21</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Anesthesia Comparative analysis Dexmedetomidine Original |
| title | A Comparative Study of Epidural Anesthesia with Dexmedetomidine Infusion versus General Anesthesia for Percutaneous Nephrolithotomy |
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