Journal of endourology
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Journal of endourology · Apr 2015
Randomized Controlled TrialRetrograde intrarenal surgery with combined spinal-epidural vs general anesthesia: a prospective randomized controlled trial.
Retrograde intrarenal surgery (RIRS) involves a minimally invasive stone surgery, lending itself potential to combined spinal-epidural anesthesia (CSEA), although it is performed preferably under general anesthesia (GA). This prospective randomized study was undertaken to evaluate the feasibility and efficacy of CSEA for patients undergoing RIRS. ⋯ RIRS with CSEA can be completed with no anesthetic conversions and with the same efficacy and safety compared with GA. When considering economical aspects, CSEA appears to be a preferable alternative to GA for the patient whose general health status permits it.
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Journal of endourology · Mar 2015
Randomized Controlled TrialThe effect of dexmedetomidine on intraocular pressure increase in patients during robot-assisted laparoscopic radical prostatectomy in the steep Trendelenburg position.
This study was to evaluate the effect of intraoperative continuous infusion of dexmedetomidine on intraocular pressure (IOP) in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALRP) in the steep Trendelenburg (ST). ⋯ Intraoperative continuous infusion of dexmedetomidine may help alleviate IOP increase in patients undergoing RALRP in the ST position.
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Journal of endourology · Dec 2014
Randomized Controlled TrialWhich is the preferred modality of renal access for a trainee urologist: ultrasonography or fluoroscopy? Results of a prospective randomized trial.
In percutaneous nephrolithotomy (PCNL), placement of the access tract into the kidney is an important aspect of the procedure and is responsible for the steep learning curve associated with the operation. The aim of the current prospective randomized trial was to assess the duration of radiation exposure along with the safety and efficacy of PCNL done by a trainee, utilizing either ultrasonography (US) or fluoroscopic guidance to obtain access. ⋯ Both ultrasound and fluoroscopic guidance for renal access are equally safe and feasible in the hands of a trainee urologist. Total fluoroscopy duration and exposure time during puncture were both significantly less in the ultrasound group. Expertise in fluoroscopic-guided access is essential for a novice to effectively achieve access in all possible situations.
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Journal of endourology · Nov 2014
Randomized Controlled TrialIntermittent perirenal instillation of bupivacaine after tubeless percutaneous nephrolithotomy under spinal anesthesia: a double-blind, placebo-controlled clinical trial.
Pain at the surgery site is a common complaint in patients who experience percutaneous nephrolithotomy (PCNL). The aim of this double-blind, randomized clinical trial is evaluation of the effect of scheduled infusion of bupivacaine on postsurgical pain and narcotic consumption after tubeless PCNL under spinal anesthesia. ⋯ Intermittent perirenal instillation of bupivacaine via the nephrostomy tract after PCNL decreases the need for more systemic narcotics and provides acceptable analgesia in the postoperative period.
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Journal of endourology · Sep 2014
Randomized Controlled TrialAnalgesic efficacy of paravertebral bupivacaine during percutaneous nephrolithotomy: an observer blinded, randomized controlled trial.
A unilateral paravertebral (PVB) block with catheter can provide extendable analgesia without physiological changes. The objective of this study was to assess the efficacy of PVB bupivacaine for providing perioperative pain relief in adults undergoing percutaneous nephrolithotomy (PCNL) under general anesthesia. ⋯ Unilateral PVB block with catheter provided effective perioperative analgesia for PCNL.