Intermittent Perirenal Instillation of Bupivacaine After Tubeless Percutaneous Nephrolithotomy Under Spinal Anesthesia: A Double-Blind, Placebo-Controlled Clinical Trial

Sharifi, Seyed Hossein Hosseini; Soltani, Mohammad Hossein; Rezaeetalab, Gholam Hossein; Sharif, Reyhaneh Yamini; Khaledi, Flora; Lashay, Alireza; Sharifiaghdas, Farzaneh

doi:10.1089/end.2014.0408

Cited by 4 publications

(3 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Scientific findings support using paravertebral block or epidural anesthesia before PCNL to minimize the postoperative pain [ 16 , 17 ]. Local injection of analgesic drugs is also effective for this treatment [ 18 , 19 , 20 , 21 ]. Preventive preoperative intravenous or subarachnoid spinal analgesia was also described [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Erector Spinae Plane Block for Perioperative Analgesia after Percutaneous Nephrolithotomy

Bryniarski

Białka

Kępiński

et al. 2021

IJERPH

View full text Add to dashboard Cite

Erector spinae plane block was recently introduced as an alternative to postoperative analgesia in surgical procedures including thoracoscopies and mastectomies. There are no clinical trials regarding erector spinae plane block in percutaneous nephrolithotomy. The aim of our study was to test the efficacy and safety of erector spinae plane block after percutaneous nephrolithotomy. We analyzed 68 patients, 34 of whom received erector spinae plane block. The average visual analogue scale score 24 h postoperatively was the primary endpoint. The secondary endpoints were nalbuphine consumption and the need for rescue analgesia. Safety measures included the mean arterial pressure, Ramsey scale score, and rate of nausea and vomiting. The visual analogue scale, blood pressure, and Ramsey scale were assessed simultaneously at 1, 2, 4, 6, 12, and 24 h postoperatively. The average visual analogue scale was 2.9 and 3 (p = 0.65) in groups 1 (experimental) and 2 (control), respectively. The visual analogue scale after 1 h postoperatively was significantly lower in the erector spinae plane block group (2.3 vs. 3.3; p = 0.01). The average nalbuphine consumption was the same in both groups (46 mL vs. 47.2 mL, p = 0.69). The need for rescue analgesia was insignificantly different in both groups (group 1, 29.4; group 2, 26.4%; p = 1). The mean arterial pressure was similar in both groups postoperatively (91.8 vs. 92.5 mmHg; p = 0.63). The rate of nausea and vomiting was insignificantly different between the groups (group 1, 17.6%; group 2, 14.7%; p = 1). The median Ramsey scale in all the measurements was two. Erector spinae plane block is an effective pain treatment after percutaneous nephrolithotomy but only for a very short postoperative period.

show abstract

Section: Discussionmentioning

confidence: 99%

Erector Spinae Plane Block for Perioperative Analgesia after Percutaneous Nephrolithotomy

Bryniarski

Białka

Kępiński

et al. 2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…Sharifi et al . [20] evaluated the efficacy of intermittent perirenal instillation of bupivacaine posttubeless PCNL under spinal anesthesia and observed that the pain score (VAS) at various time intervals and concluded that bupivacaine provided a more acceptable analgesia; however, it was statistically insignificant. Shah et al .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of intercostal nerve block with 0.25% bupivacaine in percutaneous nephrolithotomy: A prospective randomized clinical trial

Yadav

Gupta

2019

Urol Ann

View full text Add to dashboard Cite

Introduction and Aim:Several techniques have been used to lower the morbidity of percutaneous nephrostomy (PCN) tube after percutaneous nephrolithotomy (PCNL). The outcomes of intercostal nerve block (ICB) versus peritubal block (PTB) with 0.25% bupivacaine to alleviate post-PCNL pain were compared.Materials and Methods:After obtaining an informed written consent and local institutional ethics clearance, 64 patients undergoing PCNL were computer randomized to receive either an intercostal block/ICB (Group I) or a peritubal block/PTB (Group II) using 0.25% bupivacaine infiltration, after termination of the procedure. They were evaluated for visual analog scale (VAS) score, first analgesic requirement, and the total analgesic demand along with fall in hematocrit, PCN indwelling time, blood transfusion rate, complications, and mean hospital stay in the postoperative period. The protocol was registered with CTRI/2018/03/012717.Results:Patients in both the groups were comparable on the basis of demographic data, preoperative renal function, stone burden, and hematocrit value. The mean VAS score at 6, 12, 24, and 48 h was significantly lower in the Group II versus Group I (P < 0.001). The total mean analgesic requirement was 160.16 and 103.13 mg of diclofenac sodium in Group I and Group II, respectively, which was significantly higher in Group I versus Group II (P < 0.001). The time to first analgesic demand was significantly higher in PT group (8.06 ± 1.99 h vs. 12.97 ± 1.96 h) in Group I/ICNB and Group II/PT, respectively (P < 0.001). Both the groups were comparable in terms of postoperative hematuria, hematocrit fall, nephrostomy site leak, hospital stay, need of blood transfusions, stone-free rate/retreatment rate, postoperative urinary tract infections, and overall complication rate (Modified Clavien–Dindo classification) which were not statistically significant.Conclusion:Post PCNL, PTB was associated with significantly lower post operative pain and discomfort versus ICB as demonstrated by the significantly lower DVAS pain scores, higher mean time to first analgesic demand and lower mean total analgesic demandt with ICB. Bupivacaine was a safe and effective local anesthetic agent for PTB in select patients for facilitating quick relief from the morbid postoperative pain and discomfort following PCNL.

show abstract

“…Although perhaps not sufficient by itself, LA seems to improve pain control when associated with regional anesthesia as Sharifi and colleagues reported in a randomized trial of nephrostomy tract instillation with bupivacaine after PCNL under spinal anesthesia; LA was found to decrease the need for more systemic narcotics and provide acceptable analgesia in the postoperative period. 3 …”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Bilateral Prone Percutaneous Nephrolithotomy Under Epidural in Candidate for Lung Transplant: Case Report and Review of Literature

Soares

Glaser

Cohen

et al. 2018

Journal of Endourology Case Reports

View full text Add to dashboard Cite

Background: Percutaneous nephrolithotomy (PCNL) is a procedure typically performed under general anesthesia (GA); however, many patients might be considered unfit for GA and locoregional anesthesia is their only chance to have the procedure done.Case Presentation: A 60-year-old Middle-Eastern female with end-stage lung disease underwent evaluation for lung transplant; she was found to have severe restrictive pattern on steroid and continuous oxygen therapy, pulmonary hypertension with dilated right ventricle, chronic anemia, and asthma. She had kidney stones for 10 years, having spontaneously passed several in the past. During work-up for a lung transplant, she was found to have bilateral staghorn calculi and was referred to urology for stone management before lung transplant. After insertion of a Double-J stent for management of worsening right hydronephrosis, antibiotic therapy for extended spectrum beta-lactamases Klebsiella pneumoniae, and optimization after two procedure cancellations because of new onset of cardiovascular issues, she had a simultaneous bilateral PCNL under thoracic epidural anesthesia in two stages within 48 hours without significant complications. She was rendered stone-free and a candidate to be added to the lung transplant list.Conclusion: Bilateral prone PCNL under epidural is a safe and effective option in high anesthetic risk patients.

show abstract

Intermittent Perirenal Instillation of Bupivacaine After Tubeless Percutaneous Nephrolithotomy Under Spinal Anesthesia: A Double-Blind, Placebo-Controlled Clinical Trial

Abstract: Intermittent perirenal instillation of bupivacaine via the nephrostomy tract after PCNL decreases the need for more systemic narcotics and provides acceptable analgesia in the postoperative period.

Cited by 4 publications

References 18 publications

Erector Spinae Plane Block for Perioperative Analgesia after Percutaneous Nephrolithotomy

Erector Spinae Plane Block for Perioperative Analgesia after Percutaneous Nephrolithotomy

Efficacy of intercostal nerve block with 0.25% bupivacaine in percutaneous nephrolithotomy: A prospective randomized clinical trial

Bilateral Prone Percutaneous Nephrolithotomy Under Epidural in Candidate for Lung Transplant: Case Report and Review of Literature

Contact Info

Product

Resources

About