Hemodynamic Effects of Surgical Position in Prone vs. Supine Percutaneous Nephrolithotomy
Trial Parameters
Brief Summary
This prospective, randomized controlled study evaluates the hemodynamic effects of prone and supine positions during percutaneous nephrolithotomy (PNL) for large kidney stones. Surgical position may influence intraoperative and postoperative hemodynamic stability. Prone positioning can increase intrathoracic pressure and reduce venous return, whereas supine positioning may provide greater hemodynamic stability. A total of 84 patients will be randomized to undergo PNL in prone or supine positions. Primary outcomes include changes in hemodynamic parameters during surgery. Results may guide surgical position selection, especially in patients with potential hemodynamic risk.
Eligibility Criteria
Inclusion Criteria: * ASA physical status I-III * Presence of renal calculi indicated for PNL Exclusion Criteria: * Pregnancy * Uncontrolled coagulopathy * Previous renal surgery * Severe cardiac, pulmonary, or neurological disease * Preoperative urinary tract infection (non-sterile urine culture) * Surgery duration \<60 minutes or \>120 minutes * Preoperative blood transfusion * Multiple access tracts