The Effect of Surgical Position on Hemodynamics in Percutaneous Nephrolithotomy Performed in Prone and Supine Positions

What this Trial Is About

Researchers are studying the effects of surgical positioning on hemodynamic stability during percutaneous nephrolithotomy (PNL), a minimally invasive procedure to remove large kidney stones. This randomized controlled trial compares prone and supine positions to see how each impacts blood pressure, heart rate, and other cardiovascular measures during and after surgery. The goal is to provide evidence that helps guide the choice of surgical position, especially for patients who may have risks related to blood flow and heart function. The study involves 84 patients aged 18 to 80 years who are scheduled for elective PNL and have physical health status classified as ASA I-III. Participants are randomly assigned to one of two groups: one undergoing PNL in the prone position and the other in the Galdakao-modified Valdivia supine position. Both procedures include ureteral catheter placement, renal access using fluoroscopy, and stone fragmentation using pneumatic or ultrasonic lithotripters. The surgical techniques and postoperative care protocols are standardized across both groups. During the study, researchers will monitor various hemodynamic parameters such as blood pressure, heart rate, arterial blood gases, and oxygen levels from anesthesia induction through surgery and into the first postoperative day. They will also collect data on surgery duration, anesthesia time, blood loss, complications, residual stones detected by CT scan one month after surgery, nephrostomy tube duration, and length of hospital stay. These measurements will help assess the safety and cardiovascular effects of each surgical position throughout the perioperative period.

Hemodynamic Effects of Surgical Position in Prone vs. Supine Percutaneous Nephrolithotomy