title: The analgesic efficacy of peritubal infiltration of 0.25% bupivacaine in percutaneous nephrolithotomy - A prospective randomized study.
abstract: BACKGROUND
  Percutaneous nephrolithotomy is a routine endourologic procedure in patients with renal stones. Although it is less painful than open surgery, good postoperative analgesia is required to alleviate pain around nephrostomy tube.
  
  
  METHODS
  Sixty ASA grade I patients, 18 to 60 years of age, of either sex were randomized to receive 20 ml of 0.25% bupivacaine (group S) or 20 ml of normal saline (group C) through 23-gauge spinal needle along the nephrostomy tube under fluroscopic guidance at the end of the surgery. Postoperative pain score was assessed by visual and dynamic visual analog scores. When the scores were ≥4, rescue analgesia was given in the form of tramadol 1 mg/kg i.v. upto maximum 400 mg in 24 hours. Time to first demand analgesia and total dose of tramadol in first 24 hours was noted.
  
  
  RESULTS
  Pain scores at rest and during coughing as well as rescue analgesic requirements for first 24 hours were significantly less in the bupivacaine group than those of the control group (P < 0.05). The first request for demand analgesia was around 9 hours in group S, while in group C it was around 2.6 hours (P < 0.05). Total requirement of tramadol in group S was 119.3 mg and in C group it was 276.8 mg (P < 0.05).
  
  
  CONCLUSIONS
  Peritubal infiltration of 0.25% bupivacaine is efficient in alleviating postoperative pain after PCNL.
authors.affiliation: Department of Anaesthesia and Critical Care, Smt. K.M. Mehta and Smt. G.R. Doshi Institute of Kidney Diseases and Research Center, Dr. H.L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India.
authors.forename: Geeta P
authors.initials: GP
authors.lastname: Parikh
authors.forename: Veena R
authors.initials: VR
authors.lastname: Shah
authors.forename: Manisha P
authors.initials: MP
authors.lastname: Modi
authors.forename: Nikhil C
authors.initials: NC
authors.lastname: Chauhan
references.citation: J Endourol. 2009 May;23(5):857-60
references.pmid: 19397429
references.citation: J Endourol. 2003 Aug;17(6):411-4
references.pmid: 12965069
references.citation: J Endourol. 2001 Sep;15(7):711-3
references.pmid: 11697402
references.citation: J Endourol. 2007 May;21(5):499-503
references.pmid: 17523902
references.citation: J Endourol. 2011 Jan;25(1):35-9
references.pmid: 21067273
references.citation: J Urol. 1997 May;157(5):1578-82
references.pmid: 9112480
references.citation: J Endourol. 2004 Jun;18(5):475-6
references.pmid: 15253824
references.citation: Eur Urol. 2007 Jan;51(1):224-7; discussion 228
references.pmid: 16842905
references.citation: J Endourol. 2004 Aug;18(6):544-6
references.pmid: 15333218
references.citation: J Urol. 2007 Sep;178(3 Pt 1):925-8
references.pmid: 17632138
references.citation: J Urol. 2004 Aug;172(2):565-7
references.pmid: 15247731