{
    "abstract": "To systematically review the outcomes of percutaneous nephrolithotomy (PCNL) performed in local (LA) or regional anesthesia (RA) as compared to general anesthesia (GA).\nLiterature search was conducted on 12th April 2024 including PubMed, Medline, Embase, and Scopus database. Complications were assessed using the Cochran-Mantel-Haenszel Method with the random effect model and reported as odds ratio (OR), 95% confidence interval (CI), and p-values. Analyses were two-tailed and the significance was set at p\u202f<\u202f0.05 and a 95% CI. Continuous variables were pooled using the inverse variance of the mean difference with a random effect, 95% CI, and p-values.\nFourteen studies were included. Overall, there were 1413 patients, with 703 patients in the LA/RA group and 710 in the GA group. There was no difference in Clavien grade III and \u2265III complications, postoperative pain, postoperative headache, operative time, postoperative stay, stone-free rate, and intraoperative mean heart rate between LA/RA and GA. Meta-analysis shows that the nausea and vomiting rate favors the LA/RA group (OR 0.10), blood transfusion rate is lower in LA/RA group (OR 0.40), intraoperative blood loss is lower in LA/RA group (MD -59.63\u202fml) and intraoperative mean arterial pressure is lower in LA/RA group (MD -10.80\u202fmmHg).\nThis meta-analysis shows no difference in stone-free and complication rates or hospital stay if PCNL is done under GA or LA/RA. LA/RA offers advantages for better intraoperative hemodynamic stability with lesser post-operative nausea and vomiting. PCNL under RA adoption in clinical practice is perhaps limited to centers where specialist anesthetist services can support this procedure.",
    "authors": [
        {
            "affiliation": "Departamento de Urolog\u00eda, Casa di Cura Villa Igea, Ancona, Italy. Electronic address: carlo.giulioni9@gmail.com.",
            "firstname": "C",
            "initials": "C",
            "lastname": "Giulioni"
        },
        {
            "affiliation": "Departamento de Urolog\u00eda, Hospital Urol\u00f3gico Muljibhai Patel, Nadiad, India.",
            "firstname": "A",
            "initials": "A",
            "lastname": "Singh"
        },
        {
            "affiliation": "Centro de Urolog\u00eda SH Ho, Departamento de Cirug\u00eda, Universidad China de Hong Kong, Hong Kong, China.",
            "firstname": "S K",
            "initials": "SK",
            "lastname": "Yuen"
        },
        {
            "affiliation": "Unidad de Urolog\u00eda, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy.",
            "firstname": "C",
            "initials": "C",
            "lastname": "Nedbal"
        },
        {
            "affiliation": "Unidad de Urolog\u00eda, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy.",
            "firstname": "V",
            "initials": "V",
            "lastname": "De Stefano"
        },
        {
            "affiliation": "Departamento de Urolog\u00eda, Hospital General de Singapur, Singapore.",
            "firstname": "E J",
            "initials": "EJ",
            "lastname": "Lim"
        },
        {
            "affiliation": "Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil; BP-A Benefic\u00eancia Portuguesa de S\u00e3o Paulo, S\u00e3o Paulo, Brazil.",
            "firstname": "M Langer",
            "initials": "ML",
            "lastname": "Wroclawski"
        },
        {
            "affiliation": "Unidad de Urolog\u00eda, Departamento de Cirug\u00eda, Centro M\u00e9dico de la Universidad Malaya, Petaling Jaya, Malaysia.",
            "firstname": "C A",
            "initials": "CA",
            "lastname": "Chai"
        },
        {
            "affiliation": "Departamento de Ciencias Materno-Infantiles y Urol\u00f3gicas, Universidad Sapienza de Roma, Roma, Italy.",
            "firstname": "M",
            "initials": "M",
            "lastname": "Maggi"
        },
        {
            "affiliation": "Departamento de Urolog\u00eda, Casa di Cura Villa Igea, Ancona, Italy.",
            "firstname": "A",
            "initials": "A",
            "lastname": "Cafarelli"
        },
        {
            "affiliation": "Centro de Urolog\u00eda SH Ho, Departamento de Cirug\u00eda, Universidad China de Hong Kong, Hong Kong, China.",
            "firstname": "D",
            "initials": "D",
            "lastname": "Castellani"
        },
        {
            "affiliation": "Departamento de Urolog\u00eda, Colegio M\u00e9dico y Hospital de Gauhati, Guwahati, India.",
            "firstname": "R",
            "initials": "R",
            "lastname": "Tp"
        },
        {
            "affiliation": "Departamento de Anestesia, Hospital Ninewells y Escuela de Medicina, Dundee, United Kingdom.",
            "firstname": "A",
            "initials": "A",
            "lastname": "Satapathy"
        },
        {
            "affiliation": "Divisi\u00f3n de Urolog\u00eda, Hospital General Ng Teng Fong, Sistema de Salud de la Universidad Nacional, Singapore.",
            "firstname": "V",
            "initials": "V",
            "lastname": "Gauhar"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2025 AEU. Published by Elsevier Espa\u00f1a, S.L.U. All rights reserved.",
    "doi": "10.1016/j.acuroe.2025.501755",
    "journal": "Actas urologicas espanolas",
    "keywords": [
        "Anestesia general",
        "Anestesia regional",
        "Complicaciones",
        "Complications",
        "General anaesthesia",
        "Nefrolitotom\u00eda percut\u00e1nea",
        "Percutaneous nephrolithotomy",
        "Regional anaesthesia"
    ],
    "methods": null,
    "publication_date": "2025-04-20",
    "pubmed_id": "40252831",
    "results": "Fourteen studies were included. Overall, there were 1413 patients, with 703 patients in the LA/RA group and 710 in the GA group. There was no difference in Clavien grade III and \u2265III complications, postoperative pain, postoperative headache, operative time, postoperative stay, stone-free rate, and intraoperative mean heart rate between LA/RA and GA. Meta-analysis shows that the nausea and vomiting rate favors the LA/RA group (OR 0.10), blood transfusion rate is lower in LA/RA group (OR 0.40), intraoperative blood loss is lower in LA/RA group (MD -59.63\u202fml) and intraoperative mean arterial pressure is lower in LA/RA group (MD -10.80\u202fmmHg).",
    "title": "Does the type of anaesthesia influence the outcome of percutaneous nephrolithotomy? Outcomes from a meta- analysis of randomized controlled trials.",
    "xml": "<Element 'PubmedArticle' at 0x788502ebcc20>"
}