Anaesthesia for Supine and Modified Supine PNL
Anaesthetists need to be aware of the difficulties and complications specific to PNL, a well-established endourological means of kidney stone removal. Although traditionally PNL has been performed in the semi-prone or prone position, more recently some centres have been successfully performing the procedure in a supine or modified supine position. This presents some significant advantages from the viewpoint of the anaesthetist, as well as a small number of disadvantages. However, many of the anaesthetist’s concerns regarding PNL are similar whatever the position used. Patient’s features and co-morbidities should be preliminarily evaluated in order to choose the best anaesthetic technique. Intraoperative management is also described, facing not only specific PNL complications such as blood loss or septic risk but also often overlooked issues including fluid balance and thermal control.
KeywordsProne Position Regional Anaesthetic Technique Central Venous Pressure Monitoring Significant Heart Failure Sputum Retention
- 16.Yu M, Leng Y, Bai Y et al (2011) The evaluation of the effect of body positioning on intra-abdominal pressure measurement and the effect of intra-abdominal pressure at different body positioning on organ function and prognosis in critically ill patients. J Crit Care 27:222.e1–222.e6Google Scholar