Analgesic Use and Complications Following Upper Pole Access for Percutaneous Nephrolithotomy

Lightfoot, Michelle; Ng, Caleb; Engebretsen, Steven; Wallner, Caroline; Huang, Gene; Li, Roger; Alsyouf, Muhannad; Olgin, Gaudencio; Smith, Jason C.; Baldwin, D. Duane

doi:10.1089/end.2014.0035

Cited by 11 publications

(4 citation statements)

References 24 publications

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“…Young age and male sex are associated with higher narcotic use postoperatively; however, we did not find such a relationship in our study [11]. Contrary to others, we found that upper pole access in the model strengthened its predictive value (adjusted R 2 ) [12]. Interestingly, BMI had a significant negative impact on VAS assessed 1 and 2 h postoperatively, but there was no correlation in VAS assessed after 2 h. Our assumption is that patients with greater BMI have more fat tissue around the tract, which limits the spread of hematoma around the kidney after PCNL.…”

Section: Discussioncontrasting

confidence: 99%

Erector Spinae Plane Block for Perioperative Analgesia after Percutaneous Nephrolithotomy

Bryniarski

Białka

Kępiński

et al. 2021

IJERPH

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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.

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Section: Discussioncontrasting

confidence: 99%

Erector Spinae Plane Block for Perioperative Analgesia after Percutaneous Nephrolithotomy

Bryniarski

Białka

Kępiński

et al. 2021

IJERPH

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“…In this systematic study, based on the performed searches, 17 276 articles were identified, and 324 (1.88%) articles were entered into the final list after conclusive investigation and evaluation according to the checklist [ [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] ] ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

The global, prevalence, and risk factors of postoperative fever after percutaneous nephrolithotomy: A systematic review and meta-analysis

Falahatkar

Gaskarei

et al. 2024

Asian Journal of Urology

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“…Это и повреждение плевральной полости, и развитие кровотечения, и большее угловое отклонение тубусом при работе в ЧЛС, которое, растягивая ткань почки, может привести к множеству серьезных осложнений [17,18]. Помимо этого, при высоком, межреберном доступе увеличивается и болевой симптом в послеоперационном периоде в сравнении с доступами через среднюю или нижнюю группу чашечек [19]. Несмотря на трудности и риски, часто верхняя локализация доступа бы-вает необходима для конкретного клинического случая.…”

Section: результатыunclassified

Artificial intelligence for a personalized approach to percutaneous nephrolithotripsy.

K.K.,

D.S.,

A.V.

et al. 2024

ECU

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Introduction. In recent years, there has been more and more research on the creation of artificial intelligence (AI) to help diagnose and treat patients in various fields of medicine. The use of algorithms allows us to reduce the time for processing large volumes of information and give a «second opinion» to a specialist in complex and non-standard clinical cases. In order to increase the effectiveness of percutaneous nephrolithotripsy, we have created an AI algorithm to personalize approach in the surgical treatment of nephrolithiasis. Purpose. To develop a universal tool for predicting the most optimal tactics of percutaneous nephrolithotripsy depending on the clinical case. Materials and methods. The total number of patients treated at N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology and those who took part in the study amounted to 1000 people. The number of men was 419 (41.9%), women 581 (58.1%). The age of patients included in the studies ranged from 18 to 88 years (52.3±13.47). The division into Training and Holdout partitions varied depending on the target variable to obtain the most accurate result. The maximum difference in the samples was 600n and 400n (60% and 40%), the minimum 800n and 200n (80% and 20%). Data processing was carried out using IBM SPSS Statistics and Modeler programs using the neural network modeling method. Results. The accuracy of prediction for the choice of nephroscope size was 82.2%, requirement for intraoperative stent placement 93.9%, requirement for ureteroscopy or contact ureterolithotripsy 98.5%. The accuracy of the forecast for the number of puncture accesses was 92.6%, for access through the upper group 95%, for access through the middle group 91.2%, for access through the lower group 91.2%. The algorithm allows us to predict the presence of residual stones with an accuracy of 84.1%, the duration of surgical intervention is 87.3%.The number of test observations was 30. The algorithm demonstrated high accuracy of prediction (from 73.8% to 94.5%) of surgical tactics in complex clinical cases. Conclusion. The results of using the algorithm for personalized prognosis in the surgical treatment of nephrolithiasis showed high accuracy and efficiency. Further development of technology to create algorithms for each nosology and surgical interventions will reduce the time of data analysis by the attending physician, provide a «second opinion» to young specialists and standardize the approach to treatment in rare and complex clinical cases.

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Analgesic Use and Complications Following Upper Pole Access for Percutaneous Nephrolithotomy

Cited by 11 publications

References 24 publications

Erector Spinae Plane Block for Perioperative Analgesia after Percutaneous Nephrolithotomy

Erector Spinae Plane Block for Perioperative Analgesia after Percutaneous Nephrolithotomy

The global, prevalence, and risk factors of postoperative fever after percutaneous nephrolithotomy: A systematic review and meta-analysis

Artificial intelligence for a personalized approach to percutaneous nephrolithotripsy.

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