The effects of Pre-emptive Bupivacaine Infiltration of the Nephrostomy tract in patients undergoing Percutaneous Nephrolithotomy: A Randomized Controlled study

Abstract

Background Percutaneous Nephrolithotomy (PCNL) is a surgical procedure used for the removal of renal stones. The technique is minimally invasive and is often used for the removal of renal stones that are located near the pelvis. The topical administration of local anesthetics in the surgical area has been proven effective in minimizing post-operative pain after various surgical procedures. Purpose This study was conducted to compare the mean post-operative pain score in patients with pre-operative Bupivacaine infiltration of nephrostomy tract with placebo in control group of patients undergoing percutaneous Nephrolithotomy. Methods A randomized controlled trial was carried out in Department of General Surgery, Kuwait Teaching Hospital, Peshawar with diagnosis of renal stones. A total of 66 patients (33 males and 33 females) age: 16-50 years were admitted with diagnosis of renal stones. Statistical analysis was performed by using SPSS version 17. Results Patients with renal stones who underwent PCNL were randomly divided into Group A (Bupivacaine) and Group B (Placebo). The overall Average pain score for Group A was 4.15 ± 1.48 range (2 to 7) on visual analogue scale (VAS), while that for Group B was 6.06 ± 1.02 range (4 to 8) p-value < 0.05, which indicates that preoperative infiltration of bupivacaine significantly decreases the postoperative pain in patients undergoing Percutaneous Nephrolithotomy. Conclusion The study concludes that local bupivacaine infiltration along the nephrostomy tract is an effective method of management of postoperative pain after PCNL, regardless of age and gender as shown by results of the study.