Postoperative mean pain score of bupivacaine VS placebo in patient undergoing percutaneous nephrolithotomy

Arif Ali Shaikh; Shahid Hussain; Safiullah Sohu; Aamir Ali Shaikh; Riaz Hussain Mangrio; Suhail Dilawar

Abstract
Objective: To compare postoperative mean pain score of bupivacaine VS placebo in patient undergoing percutaneous nephrolithotomy (PCNL).
Methodology: This randomized controlled trial was conducted at urology ward, Jinnah Postgraduate Medical Center, Karachi from April 15 to November 2016. Sixty patients were randomized into test (Group A) and control (Group B) by lottery method. Group A received 20ml/50mg of 0.25% bupivacaine and Group B was received 20 ml of normal saline. All had standard general anesthesia. Post operatively, the VAS was used to assess the pain by an independent observer, blinded to the randomization at 6, 12 and 24 hours. After 24 hours mean of VAS was calculated and noted.
Results: Mean age of patients in groups A was 26.87±7.186 (18-45), and in groups B was 29.57±10.345 (18-60) years. In group A, 12(40%) were female and 18(60%) were male patients. In group B 15(50%) were female and 15(50%) were male patients. Mean total analgesia of the patients in groups A was 1.10±0.31 (0.96-1.24), and in groups B was 3.54±0.56 (3.36-3.78). In group A, one(3.3%) were upper calyx, 17(56.7%) middle calyx and 12(40%) lower calyx patients while in group B, 5(16.7%) were upper calyx, 12(40%) middle calyx and 13(43.3%) lower calyx patients. Mean VAS score in group A was 4.20±1.424. and in group B it was 6.20±0.182 (p=0.0001).
Conclusion: The peritubal infiltration of local anesthetic 0.25% bupivacaine after PCNL is effective in deceasing VAS scores, analgesic usage and longer pain-free period without side effects.

Key words: PCNL, kidney stone, pain and bupivacaine infiltration.

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