Abstract
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The authors have made various observations based on the study, including no difference in stone-free rate (SFR), postoperative length of stay, visual analogue score on first postoperative day, and complication rates. However, neither the stone location nor the complications are mentioned in the study. Similarly, the type of regional anesthesia (RA) used in these studies is not mentioned. 2
Despite the lack of stone location, lack of robust methodology and bias in the RCTs, the authors claim that RA demonstrated shorter operative time than general anesthesia (GA). Although this might be true, this cannot be concluded based on the study itself, especially if the stone location is not known. Furthermore, the patients were all of American Society of Anaesthesiologists score ≤III, suggesting that the use of RA has not been tested in all patients.
Although the use of RA might increase in future, without knowing the type of RA used for these patients, the equipment used, the variability in mode of assessment of SFR reservations still exists on its widespread uptake. An aspect of any RA procedure is the nature and grade of complication after the procedure, and how many patients failed RA and had a conversion to GA. 2 Both these aspects are not mentioned in the article.
The article has nice meta-analysis graphs presented, but given the context and lack of robust data supporting important aspects of the article, we agree with the authors that unless further high-quality data are obtained ideally in an RCT setting, the results may not apply to all patients.