Does a prilocaine 2% injection into the nephrostomy tract have a role in acute pain management after a lower caliceal puncture during a percutaneous nephrolithotomy? A prospective randomized study with 100 patients

Objective: The aim of this study is to evaluate the effect of a prilocaine 2% injection on the acute management of pain after a lower caliceal puncture during a percutaneous nephrolithotomy.

Materials and Methods: In this prospective randomized study, which was conducted between March, 2009 and April, 2010, 100 patients who underwent percutaneous nephrolithotomy (PCNL) were enrolled in this study. In group 1, 10 ml of saline was infiltrated. In group 2, after the operation, 10 ml of prilocaine 2% was infiltrated into the layers instead of saline. The postoperative VAS scores at 2, 4 and 24 hours and the additional analgesia requests were noted and evaluated. As a rescue analgesia, meperidine 1 mg/kg was administered intramuscularly if necessary.

Results: All of the patients requested additional analgesia within 2 hours of the operation. In 4 hours, however, 38 patients (76%) in group 1 and 14 patients (28%) in group 2 requested an additional analgesic. This difference was strongly significant (p=0.000). In 24 hours, 7 (14%) and 4 (8%) patients request additional analgesia in groups 1 and 2, respectively, which was not statistically significant (p=0.33).

Conclusion: The results of our prospective randomized study suggest that the infiltration of prilocaine 2% near the nephrostomy tract has an effect on the acute management of pain after a lower caliceal puncture during PCNL.