Spinal anesthesia for ureterorenoscopy and in situ lithotripsy for upper ureteric solitary pelvic calculi – an experience at POF hospital, Wah Cantt

Objective To evaluate the possibility of performing ureterorenoscopy and insitu lithotripsy for upper ureteric and solitary pelvic calculi under spinal anesthesia. Patients and Methods This descriptive study was conducted at POF Hospital, Wah Cant from June 2008 to December 2008. A total of 125 ASA-I patients, 75 male and 50 female, age ranging from 18 to 70 years, having upper ureteric or solitary pelvic calculi, were enrolled for the study. All received spinal anesthesia with 25G spinal needle at L3-4 interspace using 0.75% bupivacaine 15 mg and underwent ureterorenoscopy or insitu lithotripsy. Intraoperative and postoperative complications including hypotension, vomiting, pain on visual analgesia scale and duration of hospital stay were noted. Results All patients had a successful motor block of hip and knee and sensory block up to T8. All with the exception of 3 patients achieved adequate anesthesia for the procedures. Ten patients had hypotension and 4 had bradycardia intraoperatively. Vomiting occurred in 3 patients and PDPH in two. All patients were shifted to ward 4 hours post operatively after confirmation of complete reversal of block and hemodynamic stability. The average stay of all patients in the hospital was 36 hours.