Comparison of efficacy of intercostal nerve block versus peritract infiltration with 0.25% bupivacaine in percutaneous nephrolithotomy: A prospective randomized clinical trial.

Autor:	Gyawali S; Department of General Surgery, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Luitel BR; Department of Urology and Kidney Transplant Surgery, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Bhattarai AS; Department of Anesthesiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Sharma UK; Department of Urology and Kidney Transplant Surgery, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Jazyk:	angličtina
Zdroj:	Indian journal of urology : IJU : journal of the Urological Society of India [Indian J Urol] 2024 Jan-Mar; Vol. 40 (1), pp. 37-43. Date of Electronic Publication: 2023 Dec 29.
DOI:	10.4103/iju.iju_276_23
Abstrakt:	Introduction: Postoperative pain following percutaneous nephrolithotomy (PCNL) adds to the morbidity of patients requiring additional analgesia. Various modalities of pain control techniques, such as intercostal nerve block (ICNB) and peritract infiltration (PTI), are being studied for better pain management. This study compares the efficacy of ICNB with PTI for postoperative pain management. Methods: A double-blinded, prospective, randomized control study was conducted, in which 0.25% bupivacaine, either ICNB or PTI, was given at the puncture site at the end of PCNL. The primary outcome was a comparison of postoperative pain score measured with resting Visual analogue Scale (r-VAS) and dynamic VAS (D-VAS) recorded at 2 h, 4 h, 8 h, 10 h, 12 h, 24 h, and at discharge. Injection ketorolac was given as rescue analgesia. Secondary outcomes include time to first rescue analgesia and total analgesic requirement (TAR). Results: Sixty patients were randomized into two equal groups with 63.3% male and 36.6% female, with a mean age of 37.25 ± 13.09 years. In Group ICNB, 24 (40%) and 6 (10%) patients and in Group PTI, 21 (35%) and 9 (15%) patients underwent standard and mini PCNL, respectively, in each group. All cases were PCNL doen in prone position. The mean R-VAS and D-VAS scores at 2, 4, 8, 12, 24, and 48 h were similar in both groups. The mean TAR was 56.84 ± 0.33.00 mg and 55.54 ± 0.29.64 mg of injection ketorolac in Group ICNB and PTI, respectively ( P < 0.894). The time to first rescue analgesic demand were 7.11 ± 4.898 h and 6.25 ± 3.354 h ( P < 0.527). Both the groups were comparable in terms of length of hospital stay, stone clearance rate, and complication rate. Conclusion: The ICNB was as efficacious as PTI for postoperative pain control with 0.25% bupivacaine following PCNL. Competing Interests: There are no conflicts of interest. (Copyright: © 2023 Indian Journal of Urology.)
Databáze:	MEDLINE
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