title: Percutaneous nephrolithotomy under a multimodal analgesia regime.
abstract: OBJECTIVE
  To evaluate the possibility of performing percutaneous nephrolithotomy (PCNL) under a multimodal analgesia regime.
  
  
  METHODS
  During a period of 3 years, 51 patients requiring PCNL were enrolled in the study. All patients received a multimodal analgesic regime that included paracetamol, a COX(2) inhibitor, epidural morphine, and infiltration of the surgical field with local anesthetics. Percutaneous renal tract access was created with ultrasound guidance. All patients were informed about the possibility of experiencing short periods of discomfort or pain, and all patients completed a visual analog pain scale questionnaire postoperatively.
  
  
  RESULTS
  All 51 patients completed the study, and the procedure was well tolerated. Intraoperative problems or postoperative complications were attributed mainly to the procedure itself (PCNL) rather than to the analgesic regimen administered. We observed no morphine-related side effects. Patients were transferred directly back to the ward immediately after the operation. The use of analgesics postoperatively was minimal.
  
  
  CONCLUSIONS
  The use of our multimodal analgesia regime is a well-tolerated and safe alternative to general or regional anesthesia for patients undergoing PCNL.
authors.affiliation: Department of Urology, University of Thessaly, Larissa, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Aravantinos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kalogeras
authors.forename: Georgia
authors.initials: G
authors.lastname: Stamatiou
authors.forename: Elena
authors.initials: E
authors.lastname: Theodorou
authors.forename: Georgios
authors.initials: G
authors.lastname: Moutzouris
authors.forename: Anastasios
authors.initials: A
authors.lastname: Karatzas
authors.forename: Michael
authors.initials: M
authors.lastname: Melekos
mesh_terms: D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*