Nephrostomy Tract Infiltration for Pain Control After PCNL
Efficacy of Nephrostomy Tract Local Anesthetic Infiltration for Postoperative Pain Control Following Prone Percutaneous Nephrolithotomy: A Prospective Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: MUSTAFA SERDAR ÇAĞLAYAN
- Phone Number: +905074311951
- Email: serdar.09.09@hotmail.com
Study Locations
-
-
Çorum
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Çorum, Çorum, Turkey (Türkiye), 19040
- Recruiting
- Department of Urology, Hitit University Çorum Erol Olçok Training and Research Hospital, Çorum, Türkiye
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Sub-Investigator:
- AHMET TAŞCI
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Contact:
- MUSA EKİCİ
- Phone Number: +90 505 751 6341
- Email: musaekici@hitit.edu.tr
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Sub-Investigator:
- METİN KIZGIN
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adults aged 18 to 75 years
- Scheduled to undergo elective percutaneous nephrolithotomy in the prone position
- Classified as American Society of Anesthesiologists physical status I-III
- Able to understand and complete postoperative pain assessments using the Visual Analog Scale
- Willing to participate in the study
- Provision of written informed consent
Exclusion Criteria:
- Known allergy or hypersensitivity to bupivacaine or other local anesthetic agents Coagulopathy or clinically significant bleeding disorder Chronic opioid use History of a neurological disorder that may affect pain perception or assessment Neurological or psychiatric condition preventing reliable postoperative pain assessment Active urinary tract infection or sepsis American Society of Anesthesiologists physical status IV or higher Requirement for multiple percutaneous access tracts Bilateral percutaneous nephrolithotomy Requirement for postoperative intensive care Refusal or inability to provide written informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Nephrostomy Tract Bupivacaine Infiltration
Participants in this arm will receive standard postoperative systemic analgesia.
In addition, at the end of percutaneous nephrolithotomy, 20 mL of 0.25% bupivacaine will be infiltrated along the nephrostomy tract, including the skin, subcutaneous tissue, muscular layers, and tissues surrounding the nephrostomy tract.
|
A total of 20 mL of 0.25% bupivacaine will be administered by local infiltration along the nephrostomy tract at the end of surgery.
The infiltration will include the skin, subcutaneous tissue, muscular layers, and tissues surrounding the nephrostomy tract.
Other Names:
Standard postoperative systemic analgesia consisting of intravenous tramadol and intravenous paracetamol will be administered according to the institutional analgesia protocol.
Rescue opioid analgesia will be provided when clinically required.
Other Names:
|
|
Active Comparator: Standard Systemic Analgesia
Participants in this arm will receive the standard postoperative systemic analgesia protocol, including intravenous tramadol and intravenous paracetamol.
Rescue opioid analgesia will be administered when clinically required.
No local or regional analgesic intervention will be performed.
|
Standard postoperative systemic analgesia consisting of intravenous tramadol and intravenous paracetamol will be administered according to the institutional analgesia protocol.
Rescue opioid analgesia will be provided when clinically required.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative Pain Intensity Assessed Using the Visual Analog Scale
Time Frame: At 1, 6, 12, and 24 hours after surgery
|
Postoperative pain intensity will be assessed using the Visual Analog Scale (VAS).
Patients will rate their pain on a scale from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain.
VAS scores will be compared between the nephrostomy tract bupivacaine infiltration group and the standard systemic analgesia group.
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At 1, 6, 12, and 24 hours after surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time to First Rescue Analgesic Requirement
Time Frame: From the end of surgery until the first rescue analgesic administration, within the first 24 postoperative hours
|
The time from the end of surgery to the first administration of rescue analgesic medication will be recorded in minutes.
A longer duration indicates a prolonged postoperative analgesic effect.
|
From the end of surgery until the first rescue analgesic administration, within the first 24 postoperative hours
|
|
Total Opioid Consumption During the First 24 Postoperative Hours
Time Frame: During the first 24 hours after surgery
|
The total amount of opioid analgesics administered during the first 24 hours after surgery will be recorded.
When different opioid agents are used, doses will be converted to intravenous morphine milligram equivalents for comparison between groups.
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During the first 24 hours after surgery
|
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Requirement for Rescue Analgesia
Time Frame: During the first 24 hours after surgery
|
The number and proportion of participants requiring at least one dose of rescue analgesic medication will be compared between the study groups.
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During the first 24 hours after surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Shah HN, Shah RH, Sodha HS, Khandkar AA, Gokhale A. A randomized control trial evaluating efficacy of nephrostomy tract infiltration with bupivacaine after tubeless percutaneous nephrolithotomy. J Endourol. 2012 May;26(5):478-83. doi: 10.1089/end.2011.0465. Epub 2011 Dec 22.
- Arshad Z, Zaidi SZ, Jamshaid A, Qureshi AH. Post operative pain control in percutaneous nephrolithotomy. J Pak Med Assoc. 2018 May;68(5):702-704.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Urogenital Diseases
- Pain
- Neurologic Manifestations
- Postoperative Complications
- Pathologic Processes
- Male Urogenital Diseases
- Calculi
- Pathological Conditions, Anatomical
- Kidney Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urolithiasis
- Urinary Calculi
- Nephrolithiasis
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Pain, Postoperative
- Kidney Calculi
- Organic Chemicals
- Anilides
- Amides
- Aniline Compounds
- Amines
- Acetanilides
- Bupivacaine
- Acetaminophen
Other Study ID Numbers
Other Study ID Numbers
- ETIK-2026-28
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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