Endourology & Stone Disease(구연) (NP-045) 연성요관경을 이용한 신장결석 수술에서 마취 방법이 수술결과 및 신기능에 미치는 영향: 전향적, 무작위배정 연구 한림대학교 의과대학 비뇨의학과교실1 서울대학교 의과대학 마취과학교실2 서울대학교 의과대학 비뇨의학과교실3 권오성¹, 이정만², 박주현³, 조민철³, 손환철³, 정현³, 조성용³ Purpose: We analyzed the influence of anesthesia methods on surgical outcomes and renal function in retrograde intrarenal surgery (RIRS) in a prospective, randomized controlled study. Materials and Methods: Seventy patients who underwent RIRS from September 2015 to February 2017 were randomly allocated to general anesthesia (GA) or spinal anesthesia (SA) groups. Renal function was assessed using estimated glomerular filtration rate, and relative renal function was evaluated using nuclear medicine tests. Maneuverability and accessibility were evaluated after every surgery. All procedures were performed by a single experienced surgeon. Results: Stone-free rate was higher in the GA (92.3%, 36 of 39) than the SA (71.0%, 22 of 31) (p=0.019) group. Pain score was higher in the GA than in the SA group on the first postoperative morning (p=0.025), but pain scores of the two groups were similar before discharge (p=0.560). There were no differences in the changes of serum creatinine level (p=0.792) and changes of estimated glomerular filtration rate (p=0.807). Differences of relative renal function between operative and contralateral site increased significantly in patients under GA than under SA at postoperative 3 months (p=0.014). Maneuverability and accessibility were better in SA with sedation than GA (p<0.001). Conclusions: There were no significant differences in changes of serum creatinine level and estimated glomerular filtration rate between GA and SA. Performance of operator under SA was worse than that under GA and significantly improved with sedation. RIRS under SA showed advantages in lower pain score at postoperative first day. keywords : renal stone, retrograde intrarenal surgery, spinal anesthesia