Postoperative Pain Score of Bupivacaine versus Placebo in Patients Undergoing Percutaneous Nephrolithotomy

Objective: To compare postoperative mean pain score of bupivacaine versus placebo in patients undergoing percutaneous nephrolithotomy. Study Design: An experimental study. Place and Duration of Study: Department of Urology, The Kidney Centre, Postgraduate Training Institute (PGTI), Karachi, from November 2014 to December 2015. Methodology: A total of 94 patients who underwent standard percutaneous nephrolithotomy, clinically diagnosed renal stone by CT scan, KUB, X-ray or ultrasound were included in the study. Patients were randomly divided into two groups. Forty-seven patients in group A were treated with 20ml/50mg of 0.25% bupivacaine; and 47 patients in group B were treated with normal saline. Postoperatively, visual analog score was used to assess the pain at 6, 12 and 24 hours. Data was analysed using SPSS version 20.0 and student t-test was applied for comparison between the groups. Results: The average age of the patients was 37.23 +/- 11.31 years. Mean pain score in 24 hours was low in group A as compared to group B (5.22 +/- 0.76 vs. 7.85 +/- 0.78; p<0.001). Conclusion: Bupivacaine infiltration into the nephrostomy tract is a highly effective and safe in postoperative pain management for patients undergoing standard PCNL.