Optimizing postoperative pain relief with a novel technique: intraluminal lidocaine administration during retrograde...

Retrograde intrarenal surgery (RIRS) has become an increasingly preferred minimally invasive option for the management of kidney stones. However, postoperative pain remains a major clinical concern that may adversely affect patient comfort and recovery. This study aimed to evaluate whether intraluminal administration of lidocaine at the end of RIRS could effectively reduce postoperative pain and analgesic requirements.

A total of 61 patients who underwent RIRS between March and July 2024 were evaluated. Four patients were excluded due to residual stones, and five due to a history of cardiac arrhythmia, leaving 52 patients for analysis. Patients were divided into two groups according to the use of intraluminal lidocaine: Group L (Lidocaine Group, n = 27) received 100 mg of lidocaine prior to DJ stent placement, whereas Group C (Control Group, n = 25) did not. Demographic and stone-related parameters were recorded. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 1, 4, 8, 12, and 24 h, and postoperative analgesic use was documented.

No significant differences were observed between the groups regarding demographic characteristics, stone parameters, or preoperative pain scores. However, postoperative VAS scores were significantly lower in Group L at the 8th and 12th hours (p = 0.041 and p = 0.028, respectively). Moreover, total postoperative analgesic consumption was significantly lower in Group L (p = 0.027), supporting the analgesic efficacy of intraluminal lidocaine administration.

Intraluminal lidocaine administration at the end of RIRS appears to be a safe, feasible, and effective method for reducing postoperative pain and minimizing analgesic requirements. These findings suggest that the technique may contribute to improved postoperative recovery, although larger multicenter studies are warranted to confirm its clinical value.