Reply by the authors

摘要

Thank you very much for your pertinent comments. We agree with you that objective criteria for failure or inadequacy of local anesthesia (LA) and aborting the procedure were not defined in our study. We think that was the biggest defect in the study. Without the objective criteria, we could just judge the tolerance subjectively. In general, intraoperative pain is the most controversial factor to accept percutaneous nephrolithotomy (PCNL) under LA + sedation. In fact, actual intraoperative pain score much higher than 3.62 and discomfort such as nausea do occur in some patients in the initial stage of the study. However, with the personal experience increased, the incidence of intraoperative discomfort became lower in the study because the technical improvements were made.