Comparison of hemoglobin and sodium levels after percutaneous nephrolithotomy by two methods of Prone and Supine under spinal anesthesia

Introduction: Percutaneous nephrolithotomy (PCNL) is widely used as a minimally invasive procedure. On the other hand, during the PCNL surgery, there are many changes, especially in the electrolyte level. Bleeding can also be a complication of this procedure. This study aimed to compare two positions of supine and prone surgery effect on the amount of hemoglobin and sodium after surgery in the PCNL with spinal anesthesia. Methods: This study was a clinical trial on 200 patients in 4 groups (group A: 3 cc Marcaine 0.5% spinal in supine position, group B: 2 cc Marcaine 0.5% spinal + 20 micrograms fentanyl in Supine position, group C: 3 cc Marcaine 0.5% spinal in the prone position, group D: 2 cc Marcaine 0.5% spinal + 20 micrograms fentanyl in the prone position). The patientchr('39')s heart rate and blood pressure before anesthesia and performing Spinal anesthesia, after anesthesia and 10 and 15 minutes later during the operation were recorded. Also, in recovery and after leaving the recovery room, these variables were recorded. The patientchr('39')s hemoglobin and sodium levels were recorded before surgery and 24 hours after surgery. Data were analyzed using SPSS. Results: there was no significant difference between the two methods of supine and prone position with different doses of Marcaine in terms of sodium content before the change of position (p <0.05). However, there was a significant difference between the two methods of supine and prone position with different doses of Marcaine in terms of sodium level after the change of position (p <0.05). The highest amount of sodium was observed in group A and the lowest amount of sodium was observed in group B. Also, there was no significant difference between the amounts of hemoglobin between the groups. The highest mean systolic blood pressure was in the prone position followed by group D. the lowest mean systolic blood pressure was in the supine position and group A, after anesthesia. The heart rate between the two supine and prone position with different doses of Marcaine at different times had not any significant difference before the change of position until after recovery. Conclusion: The results of this study showed that there is no relationship between hemoglobin level, blood pressure, heart rate, and PCNL surgery position, but in the case of two methods of supine and prone position with different doses of Marcaine, sodium levels may have differences after a position change. So, monitoring of sodium levels is more important in PCNL surgery.

Keywords:

Hemoglobin , Sodium , Prone , Supine , Kidney Stone.