Surgical Outcomes and Renal Function Impact of Retrograde Intrarenal Surgery for Renal Stones: A Comparison of General Anaesthesia and Continuous Epidural Anaesthesia in a Retrospective Study.

Abstract

Background: Choosing the appropriate anaesthesia for retrograde intrarenal surgery (RIRS) is crucial due to its potential impact on surgical outcomes, postoperative recovery, and renal function. This retrospective study aimed to compare surgical outcomes and renal function impacts between general anaesthesia and continuous epidural anaesthesia for RIRS.

Methods: Clinical data from patients who underwent RIRS for renal stones at our hospital from January 2023 to December 2023 were retrospectively analysed. Patients were categorised into two groups: Those receiving general anaesthesia and those receiving continuous epidural anaesthesia. General patient information, surgical outcomes, renal function parameters, and postoperative pain scores were evaluated.

Results: The study included 110 patients: 51 in the general anaesthesia group and 59 in the continuous epidural anaesthesia group. Operation duration and stone clearance rates were similar across both groups. However, the epidural group had a significantly shorter hospital stay (1.28 ± 0.39 days vs 1.73 ± 0.42 days) and required less analgesia (25.86 ± 5.26 mg vs 29.56 ± 5.63 mg) (p < 0.001). Although the epidural group had higher preoperative creatinine levels, these levels significantly decreased postoperatively (0.99 ± 0.12 mg/dL vs 1.07 ± 0.11 mg/dL, p < 0.001). Pain scores at 2 hours (3.95 ± 1.28 vs 3.18 ± 1.42, p = 0.004) and 24 hours (3.75 ± 1.67 vs 3.08 ± 1.45, p = 0.027) were lower in the epidural group.

Conclusions: Continuous epidural anaesthesia may offer advantages over general anaesthesia for RIRS, including reduced hospital stays, lower analgesic requirements, potential renoprotection, and improved early postoperative pain management.