A DESCRIPTIVE STUDY OF PERIOPERATIVE COMPLICATIONS IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTRIPSY UNDER GENERAL ANAESTHESIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 94
Abstract
BACKGROUND Percutaneous Nephrolithotripsy is a commonly employed surgical technique in handling renal calculi. Because of the nature of the surgery and especially the use of irrigating fluid, patients may develop various complications like haemodynamic instability, fluid and electrolyte imbalance etc. Better understanding of these complications help improve patient care and thus patient outcome. The objective of this study is to study the occurrence of perioperative complications associated with PCNL under balanced general anaesthesia in prone position using distilled water as irrigation solution and the possible risk factors involved. MATERIALS AND METHODS 75 patients scheduled for PCNL were randomly chosen for the study and each patient was assessed for co-morbid illness, electrolyte and renal function abnormalities. Standard balanced general anaesthesia was provided and the patient was positioned prone for the procedure. Following recovery from anaesthesia, HR, BP, haematocrit along with serum sodium and potassium levels were estimated. Statistical Analysis- To analyse the proportions, Chi-square test was used for qualitative variables and paired t-test for quantitative variables. Setting and Design- Descriptive study. RESULTS Out of 75 patients 76% developed hypertension, 16% had hypertension at induction, 40% during intraoperative period and 20% in the postoperative period. Tachycardia was noted in 24%, 35% and 16% of patients during induction, intraoperative period and postoperative periods respectively. Preoperative mean haemoglobin was 13.8 gm% and postoperative mean Hb was 12.45 and the change was significant. The mean preoperative sodium level was 138.5 and postoperative value was 136.7, the change being statistically significant. Potassium did not show a significant change with the mean values before and after the procedure, 4.14 and 4.13 respectively. 60% of the patients did not have any problems. 15% had delayed recovery, while 5% had hypertension with tachycardia; 5% of the patients had airway obstruction and 1 patient had hydropneumothorax. CONCLUSION Percutaneous nephrolithotripsy is associated with significant increase in blood pressure and heart rate along with a reduction in the sodium levels
Authors and Affiliations
Santhi K. S, Jithin Mathew Abraham, Mary Albert
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