Comparison of supine and prone positioning methods on the amount of bleeding in percutaneous renal stone removal with spinal anesthesia

Authors
Ahmad Rastgarian 1
Samira Dana 2
Navid Kalani 3
Reza Sahraei 1
Reza Inalo 4
1 Anesthesiology, Critical care and pain management research center, Jahrom University of Medical Sciences, Jahrom, Iran
2 Anesthesiology resident. Jahrom University of Medical Sciences, Jahrom, Iran
3 Research center for social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
4 Department of Urology, Jahrom University of Medical Sciences, Jahrom, Iran
10.52547/jmj.17.4.33
Abstract
Introduction: In the decades since the introduction of percutaneous nephrolithotomy (PCNL), urology specialists have
proposed modifications to improve the safety and efficacy of this procedure. These modifications include different positions (supine, prone, lateral, and lateral). The aim of this study was to compare the effects of Supine and Prone on the amount of bleeding in percutaneous renal stone removal with spinal anesthesia.
Materials and Methods: This clinical trial study was performed on 200 patients (50 in each group) between 20-60 years old who had ASA class I and II anesthesia and were candidates for skin nephrolithotripsy surgery in Peymanieh
Hospital in 2019. Was. The patients were divided into supine and prone groups. Bleeding during surgery was measured in each group. Data were analyzed using SPSS 21 software and statistical tests.
Results: There was no significant difference between Supine and Peron status in terms of age (p=0.333), sex (p=1.000) and anesthesia class (p=0.663). Systolic blood pressure, diastolic and heart rate preoperatively; immediately, 10 and 15 minutes postoperatively; in recovery room; and at exit from recovery were not significantly different between the two study groups. Although the relative frequency of bleeding was less than 50 cc in the Peron group than the Supine group, this difference was not statistically significant (43.1% vs. 36.0%, p=0.503).
Conclusion: According to the results of this study, there was no significant difference between the groups in terms
of bleeding, systolic and diastolic blood pressure and heart rate in the study groups. Therefore, it seems that the position of supine or prone in PCNL surgery cannot have a significant effect on intraoperative bleeding.
Keywords
Supine
Peron
Marcaine
Bleeding
Nephrolithotomy
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