A Randomized, Double-Blinded, Placebo-Controlled Trial of Intercostal Nerve Block After Percutaneous Nephrolithotomy

Abstract

Intercostal blockade with bupivacaine significantly improves both pain control and HRQL in the early postoperative period. The effectiveness of bupivacaine disappears within 6 hours of surgery, after which narcotic use becomes indistinguishable. Intercostal nerve blockade is an easy, safe, and inexpensive method that can be used to optimize pain control after PCNL.

The Effect of Local Anesthetic Infiltration Around Nephrostomy Tract on Postoperative Pain Control after Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis

“…All included studies were reported randomization. And the method of randomization was not clearly depicted in 2 studies [13,17]. Allocation concealment was adequately conducted in 6 studies.…”

“…Finally, 5 RCTs [10,11,12,13,17] with 324 patients in the experimental group (local anesthetic infiltration group) and control group were included for meta-analysis and the random-effects model was used. Pooling data showed a significantly less consumption of analgesics after PCNL in the experimental group than in the control group (WMD -25.32, 95% CI -48.09 to -2.55, p = 0.003; fig.…”

“…The other 2 RCTs [12,13] did not refer to the analgesic demand time. The results of meta-analysis using the random effects model indicated that the time of first analgesic demand was significantly longer in the experimental group than in the control group (WMD 2.19, 95% CI 0.98-3.41, p < 0.0004; fig.…”

“…Pooling the data from the 2 studies [12,13] showed there was no statistically significant difference in hospital stay between the experimental group and the control group (WMD -1.02, 95% CI -7.84 to 5.80, p = 0.77; fig. 4c).…”

“…As of now, the infiltration of local anesthetic into percutaneous tract for pain management is being applied by some urologists [9,10]. But the efficacy of local anesthetic infiltration around nephrostomy tract on postoperative pain control is still controversial [9,10,11,12,13]. However, we pooled the data of available studies to conduct a systematic review using meta-analysis to evaluate the role of local anesthetic infiltration around nephrostomy tract on postoperative pain control and determine whether anesthetic infiltration around nephrostomy tract is a better option.…”