Pain control: comparison of percutaneous and operative nephrolithotomy

Percutaneous removal of renal calculi is an effective form of therapy with less morbidity than some other operative procedures. The narcotic requirements of 21 patients treated percutaneously were compared with a comparable group of patients treated by open nephrolithotomy. Patients treated percutaneously stayed in the hospital for 8.9 days and required 6.5 doses of narcotics. Patients treated by open surgical lithotomy remained in the hospital for 11.0 days and required 21 doses of narcotics. When compared on a daily basis, patients in the open operative group required 2.7 times more doses of narcotics than patients treated percutaneously. Percutaneous nephrolithotomy appears to be significantly less painful than operative nephrolithotomy utilizing a standard flank incision as indicated by narcotic analgesic usage.