The Effect of Peritubal Infiltration with Bupivacaine and Morphine on Postoperative Analgesia in Patients Undergoing Percutaneous Nephrolithotomy

Karaduman, İsra; Karasu, Derya; Yılmaz, Canan; Öner, Sedat; Solak, Hilal Erdem; Korfalı, Gülşen

doi:10.1155/2017/2454267

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…Karaduman et al . [17] had also compared the effect of PT infiltration with bupivacaine and morphine on postoperative analgesia in patients undergoing PCNL and compared the first analgesic demand between the two groups and demonstrated that it was 4.222 ± 3.44 h and 2.288 ± 1.50 h in the PT group and the control group, respectively, which was similar to our study. However, we did not use morphine in the study.…”

Section: Discussionsupporting

confidence: 86%

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Efficacy of intercostal nerve block with 0.25% bupivacaine in percutaneous nephrolithotomy: A prospective randomized clinical trial

Yadav

Gupta

2019

Urol Ann

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Introduction and Aim:Several techniques have been used to lower the morbidity of percutaneous nephrostomy (PCN) tube after percutaneous nephrolithotomy (PCNL). The outcomes of intercostal nerve block (ICB) versus peritubal block (PTB) with 0.25% bupivacaine to alleviate post-PCNL pain were compared.Materials and Methods:After obtaining an informed written consent and local institutional ethics clearance, 64 patients undergoing PCNL were computer randomized to receive either an intercostal block/ICB (Group I) or a peritubal block/PTB (Group II) using 0.25% bupivacaine infiltration, after termination of the procedure. They were evaluated for visual analog scale (VAS) score, first analgesic requirement, and the total analgesic demand along with fall in hematocrit, PCN indwelling time, blood transfusion rate, complications, and mean hospital stay in the postoperative period. The protocol was registered with CTRI/2018/03/012717.Results:Patients in both the groups were comparable on the basis of demographic data, preoperative renal function, stone burden, and hematocrit value. The mean VAS score at 6, 12, 24, and 48 h was significantly lower in the Group II versus Group I (P < 0.001). The total mean analgesic requirement was 160.16 and 103.13 mg of diclofenac sodium in Group I and Group II, respectively, which was significantly higher in Group I versus Group II (P < 0.001). The time to first analgesic demand was significantly higher in PT group (8.06 ± 1.99 h vs. 12.97 ± 1.96 h) in Group I/ICNB and Group II/PT, respectively (P < 0.001). Both the groups were comparable in terms of postoperative hematuria, hematocrit fall, nephrostomy site leak, hospital stay, need of blood transfusions, stone-free rate/retreatment rate, postoperative urinary tract infections, and overall complication rate (Modified Clavien–Dindo classification) which were not statistically significant.Conclusion:Post PCNL, PTB was associated with significantly lower post operative pain and discomfort versus ICB as demonstrated by the significantly lower DVAS pain scores, higher mean time to first analgesic demand and lower mean total analgesic demandt with ICB. Bupivacaine was a safe and effective local anesthetic agent for PTB in select patients for facilitating quick relief from the morbid postoperative pain and discomfort following PCNL.

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Section: Discussionsupporting

confidence: 86%

“…Karaduman et al . [17] compared the effect of PT infiltration with bupivacaine and morphine on postoperative analgesia in patients undergoing PCNL and found the mean VAS score/Dynamic visual analogue scale (DVAS) to be significantly lower in bupivacaine group. Kıraç et al .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of intercostal nerve block with 0.25% bupivacaine in percutaneous nephrolithotomy: A prospective randomized clinical trial

Yadav

Gupta

2019

Urol Ann

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“…The sample size was estimated using the effect size between the unilateral and bilateral hyperbaric buprenorphine for mean Bromage time from the pilot study. 5 The formula used was:…”

Section: Sample Size Calculationmentioning

confidence: 99%

“…The basic objective of unilateral spinal anaesthesia is to limit the nerve block exclusively to the surgery site. So important factors affecting successful unilateral subarachnoid block include baricity and volume of drug, the position of the patient, type of needle and its bevel direction and speed of injection [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

A comparative study of unilateral vs bilateral spinal anaesthesia using hyperbaric bupivacaine with buprenorphine in unilateral inguinal hernia surgery

2023

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Unilateral spinal anaesthesia can be used for inguinal hernia surgery. The advantage is that it provides a stronger block on the side of surgery and accelerated recovery of the nerve block, with better maintenance of cardiovascular stability. Hence it can be a valuable technique for high-risk patients. The aim: This randomized controlled trial was designed to evaluate the onset and duration of Sensory and motor block in both unilateral and bilateral spinal anaesthesia and the adverse effects of buprenorphine given intrathecally with 0.5 % bupivacaine for Spinal anaesthesia in patients scheduled for unilateral inguinal hernia surgery. Materials and methods: it is a сomparative two group randomized clinical study with 60 patients with 30 patients in Group U (UNILATERAL) and 30 patients in Group B (BILATERAL) is undertaken to study the changes in haemodynamics and side effects. Whereas, within the group (for the unilateral group) comparison of the time taken to reach L1, T12, T10 and the Bromage time between the surgical side and non-surgical side sides of surgery was done. Results: T10 -T12 spinal anaesthesia was achieved in both groups; the average time to anaesthetic onset in the unilateral group was 5.27±1.2 min, and in the bilateral, it was 5.90±1.02 min (p-value=0.32). Sensory and motor block lasted longer in the bilateral group when compared to the unilateral group; the incidence of side effects was limited to the occurrence of hypotension and bradycardia in the unilateral group than in the bilateral group. The success rate of unilateral spinal anaesthesia in our study was 100 %. Conclusion: Because of haemodynamic stability and faster recovery characteristics of unilateral spinal block, it can be used as a suitable technique in patients with a limited cardiovascular reserve and for outpatient anaesthesia.

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Kidney stones and the opioid epidemic: recent developments and review of the literature

Krughoff

Pais

2020

Current Opinion in Urology

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Purpose of review A public health emergency has been declared in response to rising opioid addiction and opioid-related deaths in the United States. As kidney stones have been identified as an important source of initial and repeated opioid exposures, this review seeks to describe the scope of the problem and report relevant alternatives to opioid analgesia for stones. Recent findings Recent literature summarizing the extent of opioid use among those with stones is reviewed. A number of opioid-minimizing strategies and analgesic regimens have been proposed and studied. A review of these modifications and alternatives is provided. Summary Both symptomatic renal colic and surgical interventions to address stones may prompt need for analgesia. Reducing prescribed opioids reduces both patient use and risk of diversion. Modifications in surgical technique, administration of local anesthetics, and use of systemic nonopioid analgesics have all been successfully employed.

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The Effect of Peritubal Infiltration with Bupivacaine and Morphine on Postoperative Analgesia in Patients Undergoing Percutaneous Nephrolithotomy

Cited by 4 publications

References 22 publications

Efficacy of intercostal nerve block with 0.25% bupivacaine in percutaneous nephrolithotomy: A prospective randomized clinical trial

Efficacy of intercostal nerve block with 0.25% bupivacaine in percutaneous nephrolithotomy: A prospective randomized clinical trial

A comparative study of unilateral vs bilateral spinal anaesthesia using hyperbaric bupivacaine with buprenorphine in unilateral inguinal hernia surgery

Kidney stones and the opioid epidemic: recent developments and review of the literature

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