Introduction
Percutaneous Nephrolithotomy (PCNL) is a standard treatment for large renal stones, but the choice of anaesthesia—spinal or general—can impact clinical outcomes. 
Objective
To determine the outcome of Percutaneous Nephrolithotomy under spinal versus general anaesthesia.

Methodology 
Study design was Randomized control trial done in Department of Urology, JPMC, Karachi, duration of six months from June 22, 2024 to December 23, 2024, A total of 60 patients aged between 16-65 years with physical status of I or II of American Society of Anaesthesiologists undergoing Percutaneous Nephrolithotomy were included. Group A received Spinal anaesthesia and group B received general anaesthesia. Pain score using visual analogue scale (VAS), amount of analgesic requirement, and mean change in haemoglobin level, and stone free rate were noted as outcome.

The pre- and post-procedure haemoglobin levels showed a mean reduction of 1.06 ± 0.28 g/dL, with similar changes in both groups (1.07 ± 0.29 vs. 1.05 ± 0.28 g/dL; p = 0.858). The mean VAS score was lower in the spinal anaesthesia group (2.43 ± 1.22) compared to the general anaesthesia group (3.47 ± 3.05; p = 0.091). The mean analgesia requirement was significantly less in the spinal anaesthesia group (97.60 ± 36.72 mg) compared to the general anaesthesia group (127.00 ± 49.39 mg; p = 0.011). The stone-free rate was insignificantly higher in the general anaesthesia group 21 (70.0%) compared to the spinal anaesthesia group 19 (63.3%) (p = 0.584)

The patients diagnosed with renal stones and undergoing Percutaneous Nephrolithotomy were selected. They were divided in two groups and one group received spinal anaesthesia and another group received general anaesthesia. Results were interpreted by checking mean drop in haemoglobin levels in both groups. Pain score was calculated in both groups and requirement of analgesia was also checked in both groups.

Spinal anaesthesia demonstrated superior outcomes compared to general anaesthesia in patients undergoing PCNL.