Comparison of the Efficacy and Adverse Effects of Sterile Water with Normal Saline in Percutaneous Nephrolithotomy (PCNL)

Background and 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. 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. 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. 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.