Effect of Intercostal Nerve Block and Nephrostomy Tract Infiltration With Ropivacaine on Postoperative Pain Control After Tubeless Percutaneous Nephrolithotomy: A Prospective, Randomized, and Case-controlled Trial.
Urology
; 114: 49-55, 2018 Apr.
Article
em En
| MEDLINE
| ID: mdl-29288788
ABSTRACT
OBJECTIVE:
To determine the efficacy of intercostal nerve block and nephrostomy tract infiltration (NTI) with ropivacaine in patients undergoing tubeless percutaneous nephrolithotomy (TPCNL). MATERIALS ANDMETHODS:
From February 2015 to March 2017, a total of 226 patients undergoing TPCNL were enrolled. After excluding 130 patients who failed to meet the inclusion criteria, a total of 96 eligible patients were randomized into 3 groups group I, control group (n = 32); group II, intercostal nerve block with 15 mL of 0.5% ropivacaine and epinephrine (n = 32); and group III, NTI with 20 mL of 0.25% ropivacaine and epinephrine (n = 32). Pain status was assessed at postoperative 2, 8, and 24 hours and at discharge by visual analog scale score at rest (RVAS) and on deep breathing and coughing.RESULTS:
Patient demographics and perioperative data between groups were comparable except for length of stay. Mean RVAS scores at postoperative 2 and 8 hours for group III were significantly less than those for group I (RVAS at 2 hours 2.6 vs 4.9, P = .001; RVAS at 8 hours 1.7 vs 3.3, P = .007). Mean RVAS scores at postoperative 24 hours had borderline significance (P = .050) among the 3 groups. Differences in mean deep breathing and coughing scores among groups were statistically significant (P = .002) only in the first 2 hours. All postoperative complications (5.4%, 5 per 92) were of grade 1 and not significantly different among groups.CONCLUSION:
NTI is safe and effective in alleviating early postoperative pain for patients who underwent TPCNL.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Nefrostomia Percutânea
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Nefrolitíase
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Nefrolitotomia Percutânea
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Ropivacaina
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Nervos Intercostais
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Bloqueio Nervoso
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Urology
Ano de publicação:
2018
Tipo de documento:
Article