Nephrolithiasis
Conditions
Keywords
Percutaneous Nephrolithotomy, Postoperative Analgesia, Pain Management, Regional Anesthesia, Nephrolithiasis
Brief summary
This prospective observational study aims to evaluate the effectiveness and safety of different postoperative analgesia methods used in patients undergoing percutaneous nephrolithotomy (PCNL). Analgesia techniques are determined independently by the responsible anesthesiologist as part of routine clinical practice, and the study team does not intervene in treatment decisions.
Detailed description
This is a prospective observational clinical study designed to examine the impact of various postoperative analgesia strategies on pain outcomes in patients undergoing percutaneous nephrolithotomy (PCNL). In routine practice at the participating center, regional block techniques and intravenous analgesia protocols are commonly used, and different anesthesiologists may choose different postoperative analgesia approaches. All patients will undergo standard general anesthesia according to institutional protocols. Intraoperative monitoring will include heart rate, mean arterial pressure, oxygen saturation, duration of surgery, opioid consumption, and intraoperative complications. Postoperative follow-up will include assessment of pain scores (NRS) at 0, 2, 6, 12, and 24 hours, cumulative opioid consumption, need for rescue analgesics, time to first analgesic request, incidence of postoperative nausea and vomiting (PONV), antiemetic use, patient satisfaction, and any analgesia-related adverse events. Demographic characteristics (age, sex, BMI, ASA status), stone features (location, side, volume), and intraoperative variables will be recorded. Data will be collected prospectively and stored securely. The primary goal is to compare the effect of different postoperative analgesia methods on cumulative opioid use in the first 24 hours. Secondary aims include evaluating pain scores, rescue analgesic need, intraoperative opioid use, time to first analgesic request, PONV incidence, patient satisfaction, and adverse effects.
Interventions
None listed
Sponsors
Istinye University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 18-65 years * ASA physical status I-III * Undergoing unilateral PCNL * Providing written informed consent
Exclusion criteria
* Known allergy to local anesthetics Coagulopathy or contraindication to regional anesthesia BMI \> 35 kg/m² Cognitive or communication impairment affecting pain evaluation Neurological or psychiatric disorders Musculoskeletal abnormalities Chronic opioid use, alcohol or substance abuse history Previous PCNL or open renal surgery on the same side Refusal to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cumulative opioid consumption | 24 hours | Cumulative opioid consumption in the first 24 hours |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to first analgesic request | Postoperative 24 hours | Time to first analgesic request |
| Need for rescue analgesics | 24 hours | Need for rescue analgesics |
| Pain scores at rest and during movement | 0, 2, 6, 12, and 24 hours postoperatively | Pain intensity measured using the Numeric Rating Scale (NRS), a validated 11-point pain scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst pain imaginable. Higher scores represent worse pain |
| Antiemetic medication use | 24 hours | Antiemetic medication use |
| Patient satisfaction score | 24 hours postoperatively | Patient satisfaction regarding postoperative analgesia, assessed using a Numeric Rating Scale (NRS) ranging from 0 to 10, where 0 represents no satisfaction and 10 represents the highest possible satisfaction. Higher scores indicate better satisfaction. |
| Intraoperative opioid consumption | During surgery | Intraoperative opioid consumption |
Countries
Turkey (Türkiye)
Outcome results
None listed