Efficacy of Levobupivacaine Infiltration to Nephrosthomy Tract in Combination with Intravenous Paracetamol on Postoperative Analgesia in Percutaneous Nephrolithotomy Patients

Gokten, Ozgur Elvan; Kılıçarslan, Hakan; Doğan, Hasan Serkan; Türker, Gürkan; Kordan, Yakup

doi:10.1089/end.2010.0346

Cited by 28 publications

(24 citation statements)

References 23 publications

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“…[4][5][6] However, the patient numbers in these studies were too low to have statistical power. Our study involves a larger number of patients than other similar studies.…”

Section: Discussionmentioning

confidence: 96%

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Does a prilocaine 2% injection into the nephrostomy tract have a role in acute pain management after a lower caliceal puncture during a percutaneous nephrolithotomy? A prospective randomized study with 100 patients

Akbay¹,

Koç²,

Filiz³

et al. 2012

Turkish Journal of Urology

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Original ArticleDoes a prilocaine 2% injection into the nephrostomy tract have a role in acute pain management after a lower caliceal puncture during a percutaneous nephrolithotomy? A prospective randomized study with 100 patients PNL operasyonu alt kaliks girişi sonrası trakta %2 prilokain enjeksiyonunun akut ağrı kontrolündeki etkinliği; 100 hastalık prospektif randomize çalışma Esat Kaan Akbay, Gökhan Koç, Nihat Devrim Filiz, Sıtkı Ün, Fırat Akdeniz, Yüksel Yılmaz ABSTRACTObjective: The aim of this study is to evaluate the effect of a prilocaine 2% injection on the acute management of pain after a lower caliceal puncture during a percutaneous nephrolithotomy. Materials and Methods:In this prospective randomized study, which was conducted between March, 2009 and April, 2010, 100 patients who underwent percutaneous nephrolithotomy (PCNL) were enrolled in this study. In group 1, 10 ml of saline was infiltrated. In group 2, after the operation, 10 ml of prilocaine 2% was infiltrated into the layers instead of saline. The postoperative VAS scores at 2, 4 and 24 hours and the additional analgesia requests were noted and evaluated. As a rescue analgesia, meperidine 1 mg/kg was administered intramuscularly if necessary. Results:All of the patients requested additional analgesia within 2 hours of the operation. In 4 hours, however, 38 patients (76%) in group 1 and 14 patients (28%) in group 2 requested an additional analgesic. This difference was strongly significant (p= 0.000). In 24 hours, 7 (14%) and 4 (8%) patients request additional analgesia in groups 1 and 2, respectively, which was not statistically significant (p= 0.33). Conclusion:The results of our prospective randomized study suggest that the infiltration of prilocaine 2% near the nephrostomy tract has an effect on the acute management of pain after a lower caliceal puncture during PCNL.Key words: Kidney stone; local anesthetic; nephrostomy; percutaneous nephrolithotomy; postoperative pain. ÖZETAmaç: Çalışmada PNL operasyonu sırasında %2 prilokain'in cilt, cilt altı, kas ve fasya tabakalarına enjeksiyonunun akut postoperatif ağrıya olan etkisini değerlendirmek amaçlandı. Gereç ve Yöntem:Mart 2009-Nisan 2010 arasında PNL uygulanan 100 hasta çalışmaya dahil edildi. Birinci gruptaki hastalara postoperatif 10ml SF 23G iğne ile enjekte edilirken, ikinci gruptaki hastalara aynı işlem %2 prilokain ile yapıldı. Postoperatif 2., 4. ve 24. saatlerde VAS skorları ve ek analjezik ihtiyaçları değerlendirildi. Gerekli olan hastalara IM 1mg/kg meperidin kurtarıcı ağrı kesici olarak uygulandı. Bulgular: Dışlanma kriterlerine sahip olmayan 100 PNL hastasından grup 1 ve 2'de 50'şer hasta yer aldı. Tüm hastalar postoperatif 2.saatte ek analjeziğe ihtiyaç duydular. Postoperatif 4.saatte 1.grupta 38 (%76), 2.grupta 14 (%28) hasta ek analjeziğe ihtiyaç duydu. Postoperatif 24. saatte ise grup 1 ve 2'de sırasıyla; 7 (%14), 4 (%8) hastada ek analjezik ihtiyacı oldu. Postoperatif 2. ve 24. saatlerde gruplar arasında anlamlı fark saptanmazken, 4.saatteki fark istatistiksel olarak ku...

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“…[4][5][6] However, the patient numbers in these studies were too low to have statistical power. Our study involves a larger number of patients than other similar studies.…”

Section: Discussionmentioning

confidence: 96%

“…Thus, several studies have focused on the injection of local anesthetics into the operative tract. [4][5][6] Various outcomes have been reported.…”

Section: Introductionmentioning

confidence: 99%

Does a prilocaine 2% injection into the nephrostomy tract have a role in acute pain management after a lower caliceal puncture during a percutaneous nephrolithotomy? A prospective randomized study with 100 patients

Akbay¹,

Koç²,

Filiz³

et al. 2012

Turkish Journal of Urology

View full text Add to dashboard Cite

show abstract

“…A nephrostomy tube is also the principal element that caused patient discomfort and pain. Currently, there are various options including the use of kinds of analgesics, single-dose subarachnoid spinal anesthesia, and local infiltration of anesthetic agents [1,21,22]. But proper postoperative pain management with less-invasive techniques may be the main goal.…”

Section: Discussionmentioning

confidence: 99%

“…However, it can lead to postoperative discomfort and pain. The fear of this pain usually makes patients develop anxiety before the procedure [1]. Postoperative pain was not only related to a comfortable recovery but also related to postoperative complications including pulmonary dysfunction [2].…”

Section: Introductionmentioning

confidence: 99%

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

Wang¹,

Zhang

Tan³

et al. 2016

Urol Int

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Objectives: To assess the safety and efficacy of local anesthetic infiltration around nephrostomy tract on postoperative pain control after percutaneous nephrolithotomy. Methods: This systematic review was performed based on randomized clinic trials about local anesthetic infiltration around nephrostomy tract on postoperative pain control. The weighted mean difference (WMD), with their corresponding 95% CI, was calculated to compare continuous variables. Results: Our results showed that the consumption of analgesic was less in the experimental group than in the control group (WMD -25.32, 95% CI -48.09 to -2.55, p = 0.003). There was no significant difference between the mean Visual Analog Scale (VAS) in the experimental group than the control group after 6 h while significantly lower after 24 h. The time of first analgesic demand was significantly longer in the experimental group (WMD 2.19, 95% CI 0.98-3.41). There was no significant difference between 2 groups in terms of operation time, hemoglobin (Hb) alteration, and hospital stay. Conclusion: Local anesthetic infiltration around nephrostomy tract had similar efficacy in the control group in terms of operation time, Hb alteration, and hospital stay, but offers some potential advantages in terms of analgesia requirement, the time of first analgesic demand, and VAS-24 h. However, good quality and large studies with long-term follow-up are warranted for further research.

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“…Gokten et al (16) studied the efficacy of the levobupivacaine infiltration to nephrostomy tract in combination with intravenous paracetamol on postoperative analgesia in patients of PCNL and concluded that levobupivacaine infiltration through the nephrostomy tract in combination with intravenous paracetamol infusion was safe and effective as an analgesia method after PCNL.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Peritubal Infiltration of Bupivacaine, Ropivacaine and Placebo in Percutaneous Nephrolithotomy for Post-Operative Analgesia

Vaddineni¹,

K²,

P³

et al. 2014

jemds

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BACKGROUND AND AIMS: Percutaneous nephrolithotomy (PCNL) is a safe and effective endourologic procedure in patients with renal calculi. Though it is less painful than open surgery, effective postoperative analgesia is required to reduce the pain around the nephrostomy site. Objectives of this study are to compare and evaluate the peritubal infiltration of bupivacaine, ropivacaine, and placebo from renal capsule to skin along the nephrostomy tract for postoperative analgesia in percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: A randomized controlled double blinded study was designed in 60 American Society of Anesthesiologists (ASA) grade I and II patients to assess & compare the impact of peritubal infiltration of bupivacaine, ropivacaine, saline with 23-gauge spinal needle along the nephrostomy tract after PCNL under fluoroscopic guidance. Patients were randomized into 3 groups B (bupivacaine), R (ropivacaine), S (saline/control). Each group containing 20 patients were given 20mL of respective drug at the conclusion of the procedure. Postoperative pain score and analgesic requirement for the first 24 hours were assessed by visual analog scale second hourly. Rescue analgesia with inj. Tramadol 2mg/kg was given intravenously to a maximum total dose of 400mg when pain score exceeded 4. RESULTS: Pain scores and analgesic requirement for the first 24 hours postoperatively were lesser in the B (bupivacaine) & R(ropivacaine) groups than in the S(saline/control) group of patients at all points of time and were statistically significant (p<0.005). CONCLUSION: In this study a significant difference in the pain scores and analgesic requirement was noted in saline and drug groups. Peritubal infiltration of 0.25% bupivacaine or 0.375% ropivacaine solutions is equally efficient in alleviating postoperative pain after PCNL.

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Efficacy of Levobupivacaine Infiltration to Nephrosthomy Tract in Combination with Intravenous Paracetamol on Postoperative Analgesia in Percutaneous Nephrolithotomy Patients

Abstract: Levobupivacaine infiltration through the nephrostomy tract in combination with intravenous paracetamol infusion was shown to be safe and efficacious as an analgesia method after PCNL.

Cited by 28 publications

References 23 publications

Does a prilocaine 2% injection into the nephrostomy tract have a role in acute pain management after a lower caliceal puncture during a percutaneous nephrolithotomy? A prospective randomized study with 100 patients

Does a prilocaine 2% injection into the nephrostomy tract have a role in acute pain management after a lower caliceal puncture during a percutaneous nephrolithotomy? A prospective randomized study with 100 patients

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

A Comparative Study of Peritubal Infiltration of Bupivacaine, Ropivacaine and Placebo in Percutaneous Nephrolithotomy for Post-Operative Analgesia

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