EFFECT OF PREOPERATIVE BUPIVACAINE INFILTRATION OF NEPHROSTOMY TRACT ON POST-OPERATIVE PAIN IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY: A RANDOMIZED CONTROLLED TRIAL
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Abstract
OBJECTIVES: To see the effect of bupivacaine infiltration of nephrostomytract in reducing the postoperative pain and analgesic requirements inpatients undergoing percutaneous nephrolithotomy.METHODOLOGY: This randomized controlled study was conductedat institute of kidney diseases Hayatabad Medical Complex, Peshawar,Pakistan, from June 1, 2011 to May 31, 2012. Total 66 patients (33 patientsin each group) were included in the study through consecutivenon-probability sampling technique and were randomly divided intogroup A (bupivacaine, 33 patients) and group B (placebo, 33 patients).RESULTS: Mean age was 32.2+2.7 & 31.09+2.6 years in group A & Brespectively. The mean duration of the procedure was 70.66±7.41 &72.12±.65 minutes for group A & B respectively. The overall averagepain score for group A was 4.15±1.48 on visual analogue scale, whilethat for group B was 6.06±1.02 (p < 0.05). The average pain score forfemale patient was 4.07, (range 2-7) & 6.13 (range 4-8) in group A & Brespectively. The average pain score for male patient was 4.12 (range2-7) & 6.0 (range 4-7) in group A & B respectively. The effect of ageon pain perception was not significant in this study as we included onlyadult patients (≥14 years of age) and mixed response was observed inboth groups patients of different age groups.CONCLUSION: Preoperative bupivacaine infiltration of the nephrostomytract is safe and an effective way of reducing the postoperative painand analgesic requirements avoiding the adverse effects of the opioidsor non-opioids analgesics.
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