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- Title
274: Role of Peritubal Bupivacaine Infilltration in Alleviating Post operative Pain: After Percutaneous Nephrolithotomy.
- Authors
Murthy, P. V. L. N.; Nirmala, J.; Reddy, K. Bhargava; Ramreddy, C. H.; Devraj, Rahul; Vidyasagar, S.; Suresh, Bethu; Srikanth, J.; Radhakrishna
- Abstract
Introduction: Percutaneous nephrolithotomy (PCNL), is the technique of choice for large renal stones. Though it is a minimally invasive procedure, the patient demands for good post operative analgesia. Nephrostomy tube is reported to be the main cause for postoperative pain. We hypothesize that peritubal infiltration of bupivacaine from renal capsule to the skin along the nephrostomy tube under fluoroscopy, may alleviate post operative pain. Methods: A randomized prospective study was designed to assess the impact of peritubal bupivacaine infiltration with 23 G spinal needle along the nephrostomy tract following PCNL under fluoroscopic guidance to avoide trauma. Patients undergoing single access percutaneous nephrolithotomy were randomized to receive either a fixed volume of 20ml of 0.25% bupivacaine in group B or no infiltration in group NB at the conclusion of the procedure. Postoperative pain score and analgesic requirement for the first 24hrs were assessed by in house resident doctor and also by the nursing staff using visual analogue scale and dynamic visual analogue scale who are unconnected with the study to eliminate bias. rescue analgesia being injection tramadol Hcl 50-100mg intravenously to a maximum total dose of 400mg. intermittently. Results: A total of 40 patients scheduled for PCNL were enrolled in the study. Pain scores and analgesic requirement for the first 24hrs postoperatively were significantly lesser in the group B patients than in the group NB patients at all point of time and were statistically significant (P<.005). Conclusions: In this study a significant difference in the pain scores and analgesic requirement was noted in the two groups of patients. Bupivacaine in a concentration of 0.25% solution has significantly contributed to alleviate postoperative pain and also patient satisfaction. Future studies may add narcotics as an adjuvant to provide long lasting analgesia and also a better quality of infiltration analgesia.
- Subjects
INDIA; ANALGESIA; ANALGESICS; POSTOPERATIVE pain treatment; LITHOTOMY; KIDNEY stones; RANDOMIZED controlled trials
- Publication
Indian Journal of Urology, 2008, Vol 24, pS139
- ISSN
0970-1591
- Publication type
Article