Post-Operative Pain Score Comparison of Bupivacaine Vs Placebo in Patients   Undergoing Percutaneous Nephrolithotomy

Abu Sufyan; Muhammad Rafiq Zafar; Anwaar Ahmed; Mujahid Ali; Zahoor Iqbal Mirza; Muhammad Sarwar Alvi

doi:10.51253/pafmj.v74i4.9258

Authors

Abu Sufyan Department of Urology, Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Rafiq Zafar Department of Urology, Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Anwaar Ahmed Department of Urology, Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Mujahid Ali Department of Urology, Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Zahoor Iqbal Mirza Department of Urology, Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Sarwar Alvi Department of Urology, Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i4.9258

Keywords:

Bupivacaine, Local anesthesia, Postoperative pain, Percutaneous nephrolithotomy, Visual analogue scale

Abstract

Objective: To compare post-operative pain of Bupivacaine vs placebo in patients undergoing percutaneous nephrolithotomy.

Study Design: Quasi-experimental study.

Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi Pakistan, from Aug 21 to Aug 22.

Methodology: Eighty-eight patients undergoing percutaneous nephrolithotomy who fulfilled the inclusion criteria were included in study and randomized in two equal groups (44 patients each) by lottery method, Group-A received 20ml/50mg of 0.25% Bupivacaine and Group-B received 20ml normal saline around nephrostomy tube. Post-operatively, the visual analogue scale used to measure pain score at 6, 12 and 24 hours by an independent observer, blinded to randomization. After 24 hours mean of VAS calculated and noted.

Results: Mean age of patient in Group-A was 39.40±8.42 years and in Group-B 38.00±8.67 years. There were 65 male (73.86%) and 23 female (26.13%) patients. Mean stone size was 3.00±0.68 cm and 3.006±0.63 cm in Group-A and B respectively. Median pain at 6, 12 and 24 hours was low in Group-A in comparison to Group-B with p-value <0.001. Similarly, overall pain score in 24 hours was also low in Group-A in comparison to Group-B with median (IQR) score being 4(4.33-3.67) vs 6.33(7.24-4), p<0.001. Demand of first post-operative analgesia was significantly prolonged in Group-A (256.68±23.70 minutes) than Group-B (168.72±30.86 minutes, p-value<0.001).

Conclusion: The peritubal Bupivacaine infiltration is highly effective in reducing postoperative pain for patients undergoing PCNL as compared to placebo.

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