Conscious Sedation Safe for Renal Cryoablation

Local anesthesia with conscious sedation for associated with shorter procedure and hospital stays.
Local anesthesia with conscious sedation for associated with shorter procedure and hospital stays.

Local anesthesia with conscious sedation (LACS) is safe and effective for patients undergoing percutaneous renal cryoablation for small renal masses, and, compared with general anesthesia, has the advantage of decreased procedure time and shorter hospital stays, according to a new study.

In a retrospective study, Jaime Landman, MD, of the University of California Irvine, and colleagues analyzed data from 235 patients who underwent percutaneous renal cryoablation (PRC). Of these, 153 had LACS and 82 had general anesthesia (GA).

The 2 groups were similar with respect to age, gender, body mass index, and other clinical characteristics. The mean follow-up times for the GA and LACS groups were 37 and 21 months, respectively, a significant difference between the groups.

The GA group had a significantly longer mean procedure time than the LACS group (133 vs. 102 minutes) and a significantly longer mean hospital stay (1.95 vs. 1.08 days), Dr. Landman's group reported online ahead of print in Urology.

In addition, the rate of immediate failure and disease recurrence did not differ significantly between the GA and LACS groups.

The researchers noted that, to their knowledge, the study is the first to assess differences in outcomes between GA and LACS during PRC.

The study had several limitations, including its retrospective design, which makes it prone to selection bias, Dr. Landman and his colleagues stated. In addition, the authors noted that their early experience with PRC began with the GA approach and transitioned to LACS with increasing expertise and technologic improvements.

“Accordingly, the learning curve over time may be a source of bias in comparing the GA and LACS groups.” Moreover, the longer follow-up of the GA group may be a source of bias with respect to the treatment failure outcome.

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