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Spinal and interpleural bupivacaine for percutaneous nephrolithotomy
M M Saied1, Z M Sonbul, M el-Kenawy
1Faculty of Medicine, University of Mansoura, Egypt.
Middle East Journal of Anaesthesiology
|October 1, 1991
Summary
Interpleural block (IPB) provided superior pain relief during percutaneous nephrolithotomy (PCNL) compared to meperidine-diazepam. IPB ensured a pain-free procedure and reduced postoperative analgesic needs.
Area of Science:
- Anesthesiology
- Urology
Background:
- Percutaneous nephrolithotomy (PCNL) requires effective analgesia for patient comfort and procedural success.
- Current adjuvant analgesic techniques for PCNL are being evaluated for improved efficacy.
Purpose of the Study:
- To compare the efficacy of interpleural block (IPB) as an adjuvant to spinal analgesia with meperidine-diazepam for PCNL.
- To assess pain control and postoperative analgesic requirements in patients undergoing PCNL.
Main Methods:
- A randomized study involving 25 patients undergoing PCNL with spinal analgesia.
- Group 1 (n=10) received meperidine (1 mg/kg IV) and diazepam (10 mg total dose) as adjuvant therapy.
- Group 2 (n=15) received interpleural block (IPB) with 10 ml of 0.5% plain bupivacaine as adjuvant therapy.
Main Results:
- Interpleural block (IPB) resulted in a completely pain-free operative experience for all patients in this group.
- The meperidine-diazepam group reported a pain-free experience in only 20% of patients.
- Patients receiving IPB required less frequent postoperative meperidine administration compared to the meperidine-diazepam group.
Conclusions:
- Interpleural block (IPB) is a highly effective adjuvant analgesic technique for PCNL, providing superior pain management.
- IPB offers a significant advantage in achieving intraoperative and postoperative pain relief for PCNL patients.
- The meperidine-diazepam combination was less effective in providing adequate analgesia during and after PCNL.