COMPARISON OF PERITUBAL INFILTRATION OF ROPIVACAIN AND PLACEBO IN PERCUTANEOUS NEPHROLITHOLAPAXY FOR POST OPERATIVE ANALGESIA AT SOETOMO HOSPITAL SURABAYA
Objective: To observe the effects of ropivacain peritubal infiltration in reducing postoperative pain and analgesic requirements postoperatively in patients underwent percutaneous nephrolithotomy (PNL). Material & method: Double blind randomized controlled trial on 32 patients with renal stone who underwent PNL at Soetomo General Hospital Surabaya from February until August 2017, divided into 2 groups. Experimental group (A) who received peritubal infiltration of ropivacain pre-operative, and control (placebo) group (B) Evaluation using Wong Baker pain score 2 hour post operation, time from operation until first rescue analgesia, and total analgesia given in first 24 hours. Result: Mean age was 51.81 ± 9.13 and 49.31 ± 10.53 years in group A and B respectively. Mean operation time 49.31 ± 10.53 and 89.69 ± 17.74 hours in group A and B respectively. There was no significant difference in stone complexity, nephrostomy placement and stenting between two groups. There was no significant difference of Wong Baker pain score 2 hours post operation between group A and B (p 0.72). There was no significant difference in total analgesia in the first 24 hours between group A and B (p 0.48). The time of first rescue analgesia demand was significantly longer in the experimental group (p 0.00). Conclusion: Peritubal infiltration of ropivacain in percutaneous nephrolitholapaxy is safe and effective to prolong the need of first rescue analgesia in post operative pain management which result in patients convenience.
Kavoussi L, Novick A, Partin A, Peters C. Campbell-Walsh Urology, 10th edition. Philadelphia; Elsevier Saunders: 2012. p. 1258-410.
Stoller M, Meng M. Urinary Stone Disease, The Practical Guide to Medical and Surgical Management. New Jersey: Humana Press; 2007. p. 27-35.
Tanagho E, McAninch J. Smith’s General Urology, 17th Edition. New York: The McGraw-Hill Companies Inc; 2008. p. 246-77.
Turk C, Knoll T, Petrik A, Sarica K. Guidelines on Urolithiasis European Association of Urology 2014. European Association of Urology; 2014. p. 1124-851.
Wang Y, Hou Y, Jiang F, Wang Y, Wang C. Percutaneous Nephrolithotomy for Staghorn Stones in Patients with Solitary Kidney in Prone position or in completely Supine Position: A Single-center Experience. IBJU. 2012; 38(6): 788-94.
Huang S, Chang C, Wang C. Percutaneous Nephrolithotomy for the treatment of complete staghorn stones. JTUA. 2005; 16: 169-74.
Razvi S, Zaidi Z. Percutaneous Nephrolithotomy in horse shoe kidneys. JPMA. 2007; 57: 222.
Ali S, Kumar N, Baloch U. Outcome of Percutaneous Nephrolithotomy. Journal of the College of Physicians and Surgeons Pakistan. 2014; 24(4): 261-4.
Rafie M, Jalal A, Khudhur H. Percutaneous Nephrolithotomy. Bahrain Medical Bulletin. 2014. 36: 1-6.
Khan M, Ullah A, Rahman A. Effect of Preoperative Bupivacain infiltration of Nephrostomy Tract on Post Operative Pain in Patiens Undergoing Percutaneous Nephrolithotomy: A Randomized Controlled Trial. KMUJ. 2013; 5(2): 71-75.
Jagadish V, Chaithanya K, Narasimha R, Sangamitra G. A Comparative study of Peritubal Infiltration of Bupivacain, Ropivacain and Plasebo in Percutaneous Nephrolithotomy for Post-Operative Analgesia. Journal of Evolution of Medical and Dental Sciences. 2014; 3(40): 61-68.
Kuthiala G, Chaundary G. Ropivacain: A Review of its Pharmacology and Clinical Use. Indian journal of Anesthesia. 2011; 55(2): 104-10.
Aravantinos E, Karatzas A, Gravas S. Feasibility of percutaneous nephrolithotomy under assisted local anaesthesia: A prospective study on selected patients with upper urinary tract obstruction. Eur Urol. 2007; 51: 224–8.
Dalela D, Goel A, Singh P. Renal capsular block: A novel method for performing percutaneous nephrolithotomy under local anesthesia. J Endourol. 2004; 18: 544–6.
Singh BP, Dhakad U, Re Li. Percutaneous nephrolithotomy under local infiltration anesthesia: A single-center experience of 2000 Chinese cases. Urology. 2014; 83: 679–80.
Gokten OE, Kilicarslan H, Dogan HS. Efficacy of levobupivacaine infiltration tonephrosthomy tract in combination with intravenous paracetamol on postoperative analgesia in percutaneous nephrolithotomy patients. J Endourol. 2011; 25: 35–39.
Parikh GP, Shah VR, Modi MP. The analgesic efficacy of peritubal infiltration of 0.25% bupivacaine in percutaneous nephrolithotomy – a prospective randomized study. J Anaesthesiol Clin Pharmacol. 2011; 27: 481– 4.
Haleblian GE, Sur RL, Albala DM. Subcutaneous bupivacaine infiltration and postoperative pain perception after percutaneous nephrolithotomy. J Urol. 2007; 178(3 pt 1): 925–8.
Ugras MY, Toprak HI, Gunen H. Instillation of skin, nephrostomy tract, and renal puncture site with ropivacaine decreases pain and improves ventilatory function after percutaneous nephrolithotomy. J Endourol. 2007; 21: 499–503.
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