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 factorsC 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.
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