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Abstract

Ureteroscopy and in situ lithotripsy provide an alternative treatment for patients with proximal solitary pelvic stones, but their safety and efficacy using spinal anesthesia are poorly studied. Objectives: To evaluate the safety, efficacy and patient satisfaction with spinal anesthesia during these procedures. Methods: A single-arm, prospective observational study was conducted at Islam Medical College, Sialkot, from May to October 2024, involving a total of 81 patients aged 20 to 60 years, ASA class I to III, who underwent elective ureteroscopy or lithotripsy. 15 mg of 0.75% bupivacaine was used to perform spinal anesthesia at the L3-L4 interspace. The main endpoints were success, complications, recovery times, and patient satisfaction. Other secondary outcomes were intraoperative hypotension, bradycardia, pain as measured by visual analogue scale (VAS) and post-dural puncture headache (PDPH). SPSS version 26.0 was used for statistical analysis. Results: A total of 97.5% patients completed the procedure under spinal anesthesia. The mean procedure time was 37.4 ± 6.2 min. In 53.1% of patients, the maximum sensory blockade level was T6. Hypotension (14.8%), bradycardia (6.2%), and PDPH (2.5%) were the complications. Next, postoperative pain significantly decreased over the 24 hours. In 55.6% of patients, excellent satisfaction was observed. Mean recovery time was 165.3 ± 22.4 minutes. Conclusions: Overall, spinal anesthesia for ureteroscopy and in situ lithotripsy in patients with proximal solitary pelvic stones is safe, effective, and has a high patient satisfaction rate.