DOI: 10.36347/sjams.2018.v06i08.053

Pages: 3210-3214

Percutaneous nephrolithotomy (PCNL) has become the standard treatment of large renal stones since its advent in 1990s. Post-operative pain is a common problem in patients undergoing PCNL. Several agents have been used to control this post-operative pain. This study was performed to know the efficacy of peritubal analgesic infiltration following PCNL in relieving the postoperative pain. It was a prospective randomized control study conducted in the period from March 2016 to May 2017. Total 58 patients undergoing PCNL during this period were taken in the study and divided into cases (n=30) and controls (n=28) groups. Of these patients, supracostal access was performed in 5 patients of case group and 6 patients of control group. The case group received peritubal injection with ropivacaine at the culmination of the procedure. Postoperative pain as the primary outcome was assessed by using visual analogue scale at 2, 6, 12, 24 and 48 hours postoperatively. The secondary outcomes were the total postoperative analgesic usage in 24 hours and time of the first analgesic demand. The average VAS score at 2 and 4 hours after the operation in the case group were significantly lower than the control group (P≤0.0001). Doses of analgesic usage required for controlling pain was significantly lower in case group than in the controls. The first analgesic demand was seen to be significantly delayed in the case group as compared to the control. Similar results were noted in patients undergoing supracostal access. To conclude, peritubal local anaesthetic infiltration is effective in alleviating immediate postoperative pain after PCNL even with supracostal access.