ASSESSMENT OF THE FEASIBILITY AND SAFETY OF SUPINE PER CUTANEOUS NEPHROLITHOTOMY UNDER REGIONAL ANESTHESIA FOR OBESE PATIENTS WITH A BODY MASS INDEX >30

F KHAN; S INAMULLAH

doi:10.54112/bcsrj.v2024i1.945

Authors

F KHAN Department, Lady Reading Hospital Peshawar KPK, Pakistan
S INAMULLAH Department, Lady Reading Hospital Peshawar KPK, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.945

Keywords:

Obesity, Nephrolithiasis, Percutaneous Nephrolithotomy (PCNL), Regional Anesthesia (RA), Supine Position

Abstract

In the realm of urology, particularly in addressing nephrolithiasis, obesity (characterized by a body mass index (BMI) exceeding 30 kg/m²) poses considerable challenges. Percutaneous nephrolithotomy (PCNL), traditionally conducted in the prone position, stands as the benchmark for removing kidney stones. The adoption of the supine position offers potential benefits, including enhanced respiratory function and simplified anesthetic access. This research evaluates the effectiveness, safety, and practicality of employing supine PCNL with regional anesthesia (RA) for obese individuals. Methods: The study was conducted at Urology Department, Lady Reading Hospital Peshawar KPK, Pakistan in the duration from January 2023 to December, 2023, comprising 200 obese patients (BMI > 30 kg/m²) who received supine PCNL under RA. The main metrics assessed were the rate of procedural success, duration of operation, and hospitalization period. Secondary metrics involved rates of complications, stone clearance, and patient satisfaction. Statistical analysis was conducted using SPSS version 25, setting the significance threshold at p < 0.05. Results: This analysis encompassed 200 participants, averaging 45.3 years old with a mean BMI of 38.7 kg/m². The success rate of the procedures stood at 95%, with operations averaging 95.8 minutes and hospital stays around 3.1 days. Complications were noted in 16.5% of cases, with 3.5% being severe. The rate of stone-free outcomes was 88%, and the average patient satisfaction was rated at 8.7 out of 10. Notably, higher BMI correlated with prolonged operation times and a higher incidence of complications. Conclusion: Supine PCNL under RA proves to be a secure, viable, and effective method for treating obese patients, yielding high success rates, manageable operation durations, and robust safety outcomes. These results advocate for the integration of supine positioning and RA in clinical settings, especially for high-risk obese patients, as they likely enhance perioperative results and patient contentment.

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