The effects of position and predictive factors on hypotension in patients undergoing prone percutaneous nephrolithotomy

Year 2026, Volume: 6 Issue: 1, 25 - 33, 12.03.2026

Seyda Ozgunay , Şermin Eminoglu , Salim Zengin , Selim Yırtımcı , Tuğba Onur , Osman Sıla Aydın

https://doi.org/10.66235/kumj.1906298

https://izlik.org/JA26PX95AU

Abstract

Aims: This study was designed to investigate the effect of prone position and predictive factors on hypotension in patients performing percutaneous nephrolithotomy.

Methods: Patients aged >18 years and ASA I-III who underwent general or regional anaesthesia were included in the study. Percutaneous access was performed in all patients with fluoroscopy in the prone position. Age, gender, body mass index, smoking, type of anaesthesia, duration of anaesthesia and surgery were recorded. The ECG, SpO2, and non-invasive blood pressure values were recorded intraoperatively. Preoperative and postoperative 12th-hour Hb, BUN, Cr, Na, K and Cl were measured in a blood sample. Isotonic was used as an intravenous fluid in all patients. In the treatment of hypotension, routine ephedrine treatments were recorded.

Results: The study included 153 patients, 49 with hypotension in Group H and 104 without hypotension in Group N. Hypertension and coronary artery disease increased the incidence of hypotension (respectively, p=0.028, p=0.007). Patients with hypotension had higher body mass index (p=0.044). Hypotension was found to be significantly higher in patients who underwent regional anaesthesia and had a large number of percutaneous accesses (respectively, p=0.048, and p=0.012). Age-Adjusted Charlson Index, ASA, smoking, and hospital stay were not statistically different.

Conclusion: Hypertension and coronary artery disease increased the risk of hypotension during PCNL procedures in the prone position. In addition, high body mass index, an increase in the number of percutaneous accesses, and the use of regional anaesthesia also increase the risk of hypotension during the performance of percutaneous nephrolithotomy procedures.

Keywords

Nephrolithotomy , hypotension , prone position , predictive factors

Ethical Statement

Ethical approval for the study was obtained from the Non-Interventional Research Ethics Committee of Bursa Yuksek Ihtisas Training and Research Hospital, Date: 17.03.2021, Decision No: 2011-KAEK-25 2021/03-14.

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