COMPARISON OF PERITUBAL INFILTRATION OF ROPIVACAIN AND PLACEBO IN PERCUTANEOUS NEPHROLITHOLAPAXY FOR POST OPERATIVE ANALGESIA AT SOETOMO HOSPITAL SURABAYA

##plugins.themes.bootstrap3.article.main##

##plugins.themes.bootstrap3.article.sidebar##

PDF
Published 2018-07-26
Arley Sadra Telussa Lukman Hakim Doddy M Soebadi

Abstract

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.


##plugins.themes.bootstrap3.article.details##

Keywords

Percutaneous nephrolitholapaxy, ropivacaine, renal stone, postoperative pain

References

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.

Section
Articles
Copyright Information
Department of Urology, Faculty of Medicine/Airlangga University