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
This prospective, randomized, controlled clinical trial aims to evaluate the effectiveness of nephrostomy tract local anesthetic infiltration for postoperative pain control in patients undergoing prone percutaneous nephrolithotomy. Eligible patients will be randomly assigned to either a control group receiving standard systemic postoperative analgesia or an intervention group receiving standard analgesia plus infiltration of 20 mL of 0.25% bupivacaine along the nephrostomy tract at the end of surgery. Postoperative pain will be assessed using the Visual Analog Scale at 1, 6, 12, and 24 hours. Secondary outcomes will include time to first analgesic requirement, total opioid consumption during the first 24 hours, need for rescue analgesia, time to mobilization, length of hospital stay, and treatment-related complications. The study is designed to determine whether nephrostomy tract infiltration provides a simple, safe, and effective adjunct for reducing pain and analgesic consumption after percutaneous nephrolithotomy.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
Studiecontact
- Naam: MUSTAFA SERDAR ÇAĞLAYAN
- Telefoonnummer: +905074311951
- E-mail: serdar.09.09@hotmail.com
Studie Locaties
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Çorum
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Çorum, Çorum, Turkije (Türkiye), 19040
- Werving
- Department of Urology, Hitit University Çorum Erol Olçok Training and Research Hospital, Çorum, Türkiye
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Onderonderzoeker:
- AHMET TAŞCI
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Contact:
- MUSA EKİCİ
- Telefoonnummer: +90 505 751 6341
- E-mail: musaekici@hitit.edu.tr
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Onderonderzoeker:
- METİN KIZGIN
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Adults aged 18 to 75 years
- Scheduled to undergo elective percutaneous nephrolithotomy in the prone position
- Classified as American Society of Anesthesiologists (ASA) physical status I-III
- Able to understand and complete postoperative pain assessments using the Visual Analog Scale (VAS)
- 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 (ASA) 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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Preventie
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
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Experimenteel: 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.
Andere namen:
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.
Andere namen:
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Actieve vergelijker: 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.
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Postoperative Pain Intensity Assessed Using the Visual Analog Scale
Tijdsspanne: At 1, 6, 12, and 24 hours after surgery
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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. |
At 1, 6, 12, and 24 hours after surgery
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Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Time to First Rescue Analgesic Requirement
Tijdsspanne: From the end of surgery until the first rescue analgesic administration, within the first 24 postoperative hours
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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
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Total Opioid Consumption During the First 24 Postoperative Hours
Tijdsspanne: During the first 24 hours after surgery
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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. |
During the first 24 hours after surgery
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Requirement for Rescue Analgesia
Tijdsspanne: During the first 24 hours after surgery
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The number and proportion of participants requiring at least one dose of rescue analgesic medication will be compared between the study groups. |
During the first 24 hours after surgery
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Medewerkers en onderzoekers
Sponsor
Sponsor
Publicaties en nuttige links
Algemene publicaties
- 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.
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Urogenitale ziekten
- Pijn
- Neurologische manifestaties
- Postoperatieve complicaties
- Pathologische processen
- Mannelijke urogenitale ziekten
- Berekeningen
- Pathologische aandoeningen, anatomisch
- Nier Ziekten
- Urologische ziekten
- Vrouwelijke urogenitale ziekten
- Vrouwelijke urogenitale ziekten en zwangerschapscomplicaties
- Urolithiase
- Urinewegen
- Nefrolithiase
- Pathologische aandoeningen, tekenen en symptomen
- Tekenen en symptomen
- Pijn, postoperatief
- Nierstenen
- Organische chemicaliën
- Anilides
- Amides
- Aniline -verbindingen
- Amines
- Acetaniliden
- Bupivacaïne
- Paracetamol
Andere studie-ID-nummers
Andere studie-ID-nummers
- ETIK-2026-28
Plan Individuele Deelnemersgegevens (IPD)
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Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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