Application of the American Society of Anesthesiologists classification in treating patients with percutaneous nephrolithotomy under local anesthesia for upper urinary tract calculi
- VernacularTitle:美国麻醉医师协会分级在局部麻醉经皮肾镜碎石取石术的上尿路结石患者中的应用评价
- Author:
Xiaojian HU
1
;
Xiaoping DANG
;
Liang ZHENG
;
Zhigang ZHANG
;
Bin NIU
;
Feng NI
;
Jiangong DANG
Author Information
- Publication Type:Research Article
- Keywords: the American Society of Anesthesiologists classification; local anesthesia; percutaneous nephrolithotomy; upper urinary tract calculi; inflammatory response; complications
- From: Journal of Clinical Medicine in Practice 2024;28(10):35-38
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the application value of the American Society of Anesthesiologists (ASA) classification in treating patients with percutaneous nephrolithotomy (PCNL) under local anesthesia for upper urinary tract calculi. Methods A total of 80 patients with PCNL under local anesthesia for upper urinary tract calculi were divided into high-risk group (ASA Ⅲ to Ⅳ level) with 36 cases and low-risk group (ASA Ⅰ to Ⅱ level) with 44 cases according to ASA classification, and perioperative indicators (operation time, intraoperative blood loss and hospital stay), stone clearance rate, inflammatory factors[C reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], score of the Visual Analogue Scale (VAS) for pain, and the incidence of complications were compared between the two groups. Results Hospital stay in the low-risk group was significantly shorter than that in the high-risk group (
P < 0.05); the stone clearance rate was 93.18% in the low-risk group, which was significantly higher than 75.00% in the high-risk group (P < 0.05). Before surgery, the levels of serum CRP, IL-6 and TNF-α in the high-risk group were significantly higher than those in the low-risk group (P < 0.05); one day after surgery, the levels of serum CRP, IL-6 and TNF-α in the high-risk group were significantly higher than those in the low-risk group (P < 0.05). On the first, the third, and the fifth day after surgery, the VAS score in the high-risk and low-risk groups decreased significantly, and the VAS score in the low-risk group was significantly lower than that in the high-risk group (P < 0.05). Incidence rate of complications in the low-risk group was 4.54%, which was significantly lower than 19.44% in the high-risk group (P < 0.05). Conclusion Application of PCNL under local anesthesia in treating patients with upper urinary tract calculi of ASA Ⅰ to Ⅲ has milder inflammation and pain when compared to those of ASA Ⅲ to Ⅳ, and the incidence rate of complications is relatively low.
