Spinal Anesthesia versus General Anesthesia in the Endoscopic Management of Proximal Ureteral Stones: A Critical Evaluation Focusing on the Total Anesthesia Time

Urol Int. 2024 Dec 19:1-8. doi: 10.1159/000543203. Online ahead of print.

Abstract

Introduction: This study aimed to compare spinal and general anesthesia methods in endoscopic management of proximal ureteral stones with a particular emphasis on total anesthesia time.

Methods: A total of 246 adult patients undergoing ureteroscopic management for proximal ureteral stones between January 2021 and March 2023 were enrolled. Two different types of anesthesia, namely, spinal (group 1, n = 109) and general (group 2, n = 137) anesthesia, were applied during these procedures.

Results: The mean total anesthesia time of group 1 was statistically significantly shorter than that of group 2 (61.4 ± 28.7 and 93.7 ± 29.2 min, respectively, p = 0.013). While 92.7% of patients in group 1 were stone free after the interventions, this value was 92% in group 2 (p = 0.828). There was no statistically significant difference between the two groups regarding peri- (p = 0.126) or postoperative (p = 0.284) complications.

Conclusions: Our results demonstrated well that both spinal and general anesthesia methods could be applied in a successful and safe manner in the endoscopic management of proximal ureteral stones. However, a shorter total anesthesia time under spinal anesthesia could be anticipated during endoscopic management of proximal ureteral stones.

Keywords: Endoscopy; General anesthesia; Proximal ureteral stones; Spinal anesthesia; Ureteroscopy.