Journal of endourology
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Journal of endourology · Apr 2015
Randomized Controlled TrialRetrograde intrarenal surgery with combined spinal-epidural vs general anesthesia: a prospective randomized controlled trial.
Retrograde intrarenal surgery (RIRS) involves a minimally invasive stone surgery, lending itself potential to combined spinal-epidural anesthesia (CSEA), although it is performed preferably under general anesthesia (GA). This prospective randomized study was undertaken to evaluate the feasibility and efficacy of CSEA for patients undergoing RIRS. ⋯ RIRS with CSEA can be completed with no anesthetic conversions and with the same efficacy and safety compared with GA. When considering economical aspects, CSEA appears to be a preferable alternative to GA for the patient whose general health status permits it.
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Journal of endourology · Apr 2015
Effect of postcall fatigue on surgical skills measured by a robotic simulator.
To examine the effect of a 24-hour call on residents' performance of a suturing task using the objective results calculated by the da Vinci Skills Simulator (Intuitive Surgical, Sunnyvale, CA). ⋯ Previous studies have shown that postcall-related fatigue is associated with decreased surgical skills in the operative room. We demonstrate this effect by having residents test their skills, precall and postcall, using a novel easily reproducible technique. Time to complete the three measures analyzed was significantly increased following a 24-hour call for all participants. Fatigue acts as an equalizer of abilities in that the effects of fatigue nullify the benefits of having previous robotic simulator experience.