Local Versus General Anesthesia in Pediatric Renal Biopsy: Which is Associated With Better Outcome?

Percutaneous renal biopsy (PRB) of the native kidneys of 32 Nigerian children with varied renal diseases were studied to evaluate which of the two anesthetic techniques (local or general) was associated with better outcome. The children were randomly assigned into two anesthetic groups of 16 subjects each. PRB was performed with Franklin-modified Vim-Silverman renal biopsy needle. The outcome indices in this study were, number of biopsy attempts, duration of the biopsy procedure, number of successful biopsies, episodes and duration of macrohematuria, if any, renal biopsy related trauma (RBT) and other associated complications. There were 19 boys and 13 girls. Mean ages were similar in both local (LA) (8.7 ± 4.14 years) and general anesthesia (GA) (9.9 ± 3.5 years) groups, P 0.5. The mean biopsy attempts were 3.1 ± 1.8 and 1.6 ± 1.8 in the LA and GA groups respectively (P 0.05). Mean biopsy duration was significantly longer in the LA group (21.6 ± 6.3 min) than in the GA group (7.6 ± 5.4 min), P 0.001. Number of successful biopsies were similar in both groups; 12/16 in LA group and 15/16 in the GA group, P = 0.1446. The overall success rate was 84.4%. Mean episodes and duration of macrohematuria were similar in the two groups (P 0.5). It is concluded that in the anxious, fretful and uncooperative children, GA should be the anesthetic technique of choice for kidney biopsy given the fewer biopsy attempts as well as shorter biopsy duration associated with it.