# Effective and Economical Option of Anesthesia in Retrograde Intrarenal Surgery

## TL;DR

This study compares spinal and general anesthesia for kidney stone surgery, finding spinal anesthesia to be more cost-effective and requiring less pain medication.

## Contribution

The study provides new comparative data on the cost-effectiveness and postoperative outcomes of spinal versus general anesthesia in retrograde intrarenal surgery.

## Key findings

- General anesthesia was significantly more costly than spinal anesthesia.
- Patients under general anesthesia required more postoperative analgesia in the first six hours.
- Both anesthesia methods showed similar safety and effectiveness in surgery outcomes.

## Abstract

There is only limited data in the literature showing the effect of anesthesia methods on the success of retrograd intrarenal surgery. The aim of this study was to compare and evaluate retrograd intrarenal surgery cases performed under spinal and general anesthesia in terms of effectiveness, cost, hospitalization time and complications.

A total of 337 patients who underwent retrograd intrarenal surgery due to kidney stones between 2014 and 2019 were retrospectively evaluated. In our study, the patients were divided into two groups according to the anesthesia method administered: Group 1 consisted of 172 patients who received spinal anesthesia and Group 2 comprised 165 patients administered general anesthesia. Both groups were compared in terms of demographic data, localization and size of stone, radiographic stone density, operation time, complications, need for postoperative analgesia, length of hospitalization, and stone free rate.

The cost of general anesthesia was significantly higher compared to that of spinal anesthesia (p < 0.001). The analgesia application administered within the first six postoperative hours was significantly higher in the general anesthesia group (p < 0.001). In other findings, there was no statistically significant difference between the two groups.

Retrograd intrarenal surgery can be performed with similar safety and effectiveness under both general and spinal anesthesia. However, spinal anesthesia seems to be more advantageous due to the patients' lower need for analgesics in the early postoperative period and the lower cost of the anesthetics used.