comparison of efficacy and adverse effects of sterile water and normal saline for irrigation fluid in percutneous nephrolithotripsy(PCNL)

Comparison of the Efficacy and Adverse Effects of Sterile Water with
Normal Saline in Percutaneous Nephrolithotomy (PCNL)
Sadrollah Mehrabi1,
Samira Nazari2,
Hammidreza Ghafarian Shirazi3,
Abolghasem Hadinia4,
1 Professor, Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
2 General Practitioner, Students Research committee, Yasuj University of Medical Sciences, Yasuj, Iran
3 Assistant Professor, Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
4 Lecturer, Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
(Received July 14, 2012; Accepted December 15, 2012)
Abstract
Background and purpose: The irrigation fluid that routinely used during percutaneous nephrolithotomy
(PCNL) has systemic absorption. The aim of this study was comparing the efficacy and adverse effects of sterile
water and normal saline as an irrigant fluid in PCNL.
Materials and methods: Ninety four older than 18 years old patients with renal or upper ureteral stones
that were candidate for PCNL randomly allocated in two groups. Patient with American Society of Anesthesiologists
(ASA) score 3 and 4 and history of hemolysis excluded from study. From all patient, serum base laboratory and
serum electrolyte was taken. Then, under spinal anesthesia PCNL was done with fluoroscope guidance in standard
method with use of normal saline in first group. In second group, PCNL with fluoroscope guidance in standard
method with use of sterile water was done, too. Preoperative, intraoperative and postoperative variables such as
serum sodium, potassium and haptoglobin, cost and duration of surgery, pulmonary and cardiovascular
complications compared between two groups. Data was collected and analyzed using chi-square and paired -t tests.
Results: Demographic characteristics, operation time, serum electrolytes and volume of irrigation fluid were
similar in two groups. Mean postoperative haptoglobin in group one and two were 1.15 ± 0.38 and 1.29 ± 0.53 mg/dl
respectively (P = 0.263). Mean cost in group one and two were 117,234 and 25,400 Rial, respectively and there were
no cardiovascular and pulmonary complications.
Conclusion: Use of sterile water as an irrigation fluid in PCNL is inexpensive, safe and more available and
have not more complications in compare with normal saline that can be used as an alternative fluid in PCNL
operation.
Keywords: Sterile water, normal saline, PC