Simultaneous bilateral percutaneous nephrolithotomy with subarachnoid spinal anesthesia

被引:7
作者
Nadler, RB
Monk, TG
Elashry, O
Nakada, SY
McDougall, EM
Swarm, RA
Clayman, RV
机构
[1] Washington Univ, Sch Med, Dept Surg, Div Urol Surg, St Louis, MO 63110 USA
[2] Washington Univ, Sch Med, Dept Anesthesiol, St Louis, MO 63110 USA
[3] Washington Univ, Sch Med, Dept Radiol, Mallinckrodt Inst Radiol, St Louis, MO 63110 USA
[4] Univ Wisconsin, Sch Med, Dept Surg, Div Urol, Madison, WI USA
关键词
D O I
10.1089/end.1998.12.27
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 [临床医学]; 100201 [内科学];
摘要
We report our experience performing simultaneous bilateral percutaneous nephrolithotomy (SBPN) in four patients with large stone burdens in both kidneys. We modified the previously described approach by combining SBPN with subarachnoid Duramorph (preservative-free morphine sulfate) in an effort to decrease postoperative discomfort and shorten the duration of hospitalization. These patients (study group) were then compared with a contemporary group of four patients with similar bilateral stone burdens who underwent staged bilateral percutaneous nephrolithotomies (PCNs) (control group). The comparison showed a marked advantage in hospital stay (4.8 days for the study group v 11 days for the control group) and postoperative narcotic requirement (27.5 mg of meperidine for the study group v 533 mg for the control group). All four patients were rendered stone free. This method of treatment for large bilateral renal calculi with the addition of subarachnoid Duramorph resulted in less postoperative discomfort, less morbidity, and a more rapid recovery than staged PCN or sandwich PCN/SWL/PCN.
引用
收藏
页码:27 / 31
页数:5
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