Role of spinal anesthesia in the endoscopic treatment of distal, middle, and proximal ureter stones

Sympathetic fibers of the ureter arise between 10th thoracic and 2nd lumbar segments. Nociceptive fibers reach the same segments via sympathetic pathways. An effective neural block of these segments is necessary to achieve adequate analgesia and anesthesia. Spinal anesthesia is performed successfully in endoscopic ureter stone operations as an alternative to general or epidural anesthesia with a fast onset of effect. The aim of this study was to evaluate patients who underwent ureterorenoscopy (URS) under spinal anesthesia so as to determine patient profile and anesthesia management according to the localization of stones.
Patients who underwent URS operation due to urinary stones between January 1, 2014, and December 31, 2014, were retrospectively evaluated. Patients who underwent spinal anesthesia were included. The patients were evaluated for demographic data, duration of operation, duration of hospital stay, and size and localization of stones.
A total of 111 patients, including 84 males (75.5%), were operated under spinal anesthesia. A significant sex-related difference was noted, with more ureter stones in male patients (P = 0.001). No difference was found in operation time, duration of hospitalization, and stone size among stones at different localizations of the ureter under spinal anesthesia.
No difference was found in stone localization, duration of operation, duration of hospital stay, and stone size between distal, middle, and proximally located stones under spinal anesthesia. Spinal anesthesia may be chosen for the management of anesthesia in treating stones located at all three locations of the ureter.