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International Urology and Nephrology

, Volume 37, Issue 1, pp 35–37 | Cite as

“Ambulatory PCNL” (Tubeless PCNL under Regional Anesthesia) – A Preliminary Report of 10 Cases

  • Iqbal SinghEmail author
  • Ashok Kumar
  • Praveen Kumar
Article

Abstract

Aim: We report the technique, safety, outcome and efficacy of “tubeless percutaneous nephrolithotomy (PCNL) performed under regional anesthesia” in selected cases. Methods: Patients satisfying the entry criteria for the regional block (spinal low-dose anesthesia with low-dose Bupivacaine plus Fentanyl) and tubeless procedure were subjected to a tubeless spinal PCNL The patients were followed up the next day for an ultrasonography and an x-ray of the KUB region. Results: All the ten patients were discharged uneventfully the next day (mean hospital stay-40 h). No blood transfusion and postoperative analgesics (mean post op visual analogue pain score was 2.4) were required. The mean time to return of S1 sensation, motor block and walking were 183,118 and 196.6 min respectively. There was complete stone clearance in all the cases with a mean collection of 14.5 cc was seen on the post op ultrasound. Conclusions: The present cases were reported to highlight that in a select group of patients tubeless PCNL under regional block is technically feasible and viable option. Regional block has the advantage of avoidance of general anesthesia and anaphylaxis due to use of multiple drugs. Tubeless PCNL has the advantage of avoidance of nephrostomy tube related postoperative pain discomfort and urosepsis. This synergistically (spinal + tubeless PCNL) speeds up the recovery, shortens the length of hospitalization and the analgesic requirement.

Keywords

Percutaneous nephrolithotomy (PCNL) Percutaneous nephrostomy Regional anesthesia Tubeless PCNL 

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Copyright information

© Springer 2005

Authors and Affiliations

  1. 1.Department of SurgeryUCMS & GTBHNew DelhiIndia
  2. 2.Division of Urology, Department of Surgery & Anesthesiology University College of Medical Sciences, & GTB HospitalUniversity of DelhiDelhi-95India

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