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Optimizing pain management following kidney stone surgery: can we avoid narcotics?
Matthew Demasi1, Michal Segall1, Amanda Mengotto1
1Albert Einstein College of Medicine, Bronx, NY, 10461, USA.
World Journal of Urology
|November 13, 2022
Summary
Non-opioid pain relief was as effective as opioid therapy after kidney stone surgery. This study supports non-opioid analgesics as a viable option for managing pain post-urologic procedures.
Area of Science:
- Urology
- Pain Management
- Pharmacology
Background:
- Opioids are commonly used for postoperative pain but non-narcotic alternatives are gaining traction.
- This study investigated non-opioid versus opioid therapy for pain after nephrolithiasis surgery.
Purpose of the Study:
- To compare the efficacy and safety of non-opioid analgesia (ketorolac) versus opioid analgesia (oxycodone-acetaminophen) for pain management after nephrolithiasis surgery.
- To determine if non-opioid analgesia is non-inferior to opioid analgesia in this patient population.
Main Methods:
- An open-label, randomized non-inferiority clinical trial was conducted.
- Patients undergoing ureteroscopy or percutaneous nephrolithotomy were randomized to ketorolac or oxycodone-acetaminophen.
- Pain outcomes, demographics, and adverse events were assessed one week postoperatively.
Main Results:
- Non-inferiority was demonstrated for non-opioid analgesia compared to opioid analgesia.
- Average pain scores were lower in the non-opioid group (3.20 ± 1.94) versus the opioid group (4.17 ± 1.84).
- Rates of constipation and unused pills were similar between the groups.
Conclusions:
- Non-opioid analgesia is non-inferior to opioid analgesia for pain management after kidney stone surgery.
- Non-opioid analgesics are an effective alternative for pain control in non-invasive urologic procedures.
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