EFFECT OF PREOPERATIVE BUPIVACAINE INFILTRATION OF NEPHROSTOMY TRACT ON POST-OPERATIVE PAIN IN PATIENTSUNDERGOING PERCUTANEOUS NEPHROLITHOTOMY: A RANDOMIZED CONTROLLED TRIAL

OBJECTIVES: To see the effect of bupivacaine infiltration of nephrostomy tract in reducing the postoperative pain and analgesic requirements in patients undergoing percutaneous nephrolithotomy.METHODOLOGY: This randomized controlled study was conducted at institute of kidney diseases Hayatabad Medical Complex, Peshawar,Pakistan, from June 1, 2011 to May 31, 2012. Total 66 patients (33 patients in each group) were included in the study through consecutive non-probability sampling technique and were randomly divided into group 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 B respectively. The mean duration of the procedure was 70.66±7.41 72.12±.65 minutes for group A B respectively. The overall average pain score for group A was 4.15±1.48 on visual analogue scale, while that for group B was 6.06±1.02 (p 0.05). The average pain score for female patient was 4.07, (range 2-7) 6.13 (range 4-8) in group A B respectively. The average pain score for male patient was 4.12 (range 2-7) 6.0 (range 4-7) in group A B respectively. The effect of age on pain perception was not significant in this study as we included only adult patients (≥14 years of age) and mixed response was observed in both groups patients of different age groups.CONCLUSION: Preoperative bupivacaine infiltration of the nephrostomy tract is safe and an effective way of reducing the postoperative pain and analgesic requirements avoiding the adverse effects of the opioids or non-opioids analgesics.