Effect of single-dose subarachnoid spinal anesthesia on pain and recovery after unilateral percutaneous nephrolithotomy

Cassio Andreoni, Ephrem O. Olweny, Andrew J. Portis, Chandru Sundaram, Terri Monk, Ralph V. Clayman

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose: We studied the impact of one dose of subarachnoid spinal analgesia on postoperative pain and recovery after percutaneous nephrolithotomy (PCNL). Patients and Methods: Between August 1999 and May 2000, 20 PCNL patients were randomized into two groups: Group A (N = 9), who received preoperative subarachnoid spinal analgesia with morphine sulfate, and Group B (N = 11), who received no subarachnoid spinal analgesia. Both groups were given general anesthesia, and the nephrostomy site was infiltrated with bupivacaine hydrochloride. Stone size was similar in the two groups, as were ASA classification, age, and body mass index. Pain analog scales (maximum score 10) were completed preoperatively and on the day of surgery (D0), after 1 day (D1), and after 2 days (D2). The amount of morphine sulfate equivalents (MS eq) needed, the activity level, and adverse effects were recorded. Results: In Group A, the average pain score on D0, D1, and D2 was 2.7, 3.7, and 1.4, respectively; in Group B, the average pain score was 4, 4.5, and 2, respectively (P > 0.05). The average MS eq used in Groups A and B were 8.3 v 33.8 (P = 0.002) on D0; 17.7 v 28.7 (P > 0.05) on D1; and 11.1 v 10.1 (P > 0.05) on D2. On D0, in Group A, 56% of the patients were ambulating and 11% complained of nausea, while in Group B, 0 were ambulating and 46% complained of nausea. Conclusions: A single preoperative dose of subarachnoid spinal analgesia provides a statistically significant decrease in postoperative parenteral pain medication and earlier ambulation. It also appears to reduce the amount of postoperative pain and decrease nausea.

Original languageEnglish
Pages (from-to)721-725
Number of pages5
JournalJournal of Endourology
Volume16
Issue number10
StatePublished - Dec 2002
Externally publishedYes

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Percutaneous Nephrostomy
Spinal Anesthesia
Analgesia
Postoperative Pain
Morphine
Nausea
Pain
Early Ambulation
Bupivacaine
Pain Measurement
Ambulatory Surgical Procedures
General Anesthesia
Body Mass Index

ASJC Scopus subject areas

  • Urology

Cite this

Effect of single-dose subarachnoid spinal anesthesia on pain and recovery after unilateral percutaneous nephrolithotomy. / Andreoni, Cassio; Olweny, Ephrem O.; Portis, Andrew J.; Sundaram, Chandru; Monk, Terri; Clayman, Ralph V.

In: Journal of Endourology, Vol. 16, No. 10, 12.2002, p. 721-725.

Research output: Contribution to journalArticle

Andreoni, Cassio ; Olweny, Ephrem O. ; Portis, Andrew J. ; Sundaram, Chandru ; Monk, Terri ; Clayman, Ralph V. / Effect of single-dose subarachnoid spinal anesthesia on pain and recovery after unilateral percutaneous nephrolithotomy. In: Journal of Endourology. 2002 ; Vol. 16, No. 10. pp. 721-725.
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abstract = "Purpose: We studied the impact of one dose of subarachnoid spinal analgesia on postoperative pain and recovery after percutaneous nephrolithotomy (PCNL). Patients and Methods: Between August 1999 and May 2000, 20 PCNL patients were randomized into two groups: Group A (N = 9), who received preoperative subarachnoid spinal analgesia with morphine sulfate, and Group B (N = 11), who received no subarachnoid spinal analgesia. Both groups were given general anesthesia, and the nephrostomy site was infiltrated with bupivacaine hydrochloride. Stone size was similar in the two groups, as were ASA classification, age, and body mass index. Pain analog scales (maximum score 10) were completed preoperatively and on the day of surgery (D0), after 1 day (D1), and after 2 days (D2). The amount of morphine sulfate equivalents (MS eq) needed, the activity level, and adverse effects were recorded. Results: In Group A, the average pain score on D0, D1, and D2 was 2.7, 3.7, and 1.4, respectively; in Group B, the average pain score was 4, 4.5, and 2, respectively (P > 0.05). The average MS eq used in Groups A and B were 8.3 v 33.8 (P = 0.002) on D0; 17.7 v 28.7 (P > 0.05) on D1; and 11.1 v 10.1 (P > 0.05) on D2. On D0, in Group A, 56{\%} of the patients were ambulating and 11{\%} complained of nausea, while in Group B, 0 were ambulating and 46{\%} complained of nausea. Conclusions: A single preoperative dose of subarachnoid spinal analgesia provides a statistically significant decrease in postoperative parenteral pain medication and earlier ambulation. It also appears to reduce the amount of postoperative pain and decrease nausea.",
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AU - Andreoni, Cassio

AU - Olweny, Ephrem O.

AU - Portis, Andrew J.

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AU - Monk, Terri

AU - Clayman, Ralph V.

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N2 - Purpose: We studied the impact of one dose of subarachnoid spinal analgesia on postoperative pain and recovery after percutaneous nephrolithotomy (PCNL). Patients and Methods: Between August 1999 and May 2000, 20 PCNL patients were randomized into two groups: Group A (N = 9), who received preoperative subarachnoid spinal analgesia with morphine sulfate, and Group B (N = 11), who received no subarachnoid spinal analgesia. Both groups were given general anesthesia, and the nephrostomy site was infiltrated with bupivacaine hydrochloride. Stone size was similar in the two groups, as were ASA classification, age, and body mass index. Pain analog scales (maximum score 10) were completed preoperatively and on the day of surgery (D0), after 1 day (D1), and after 2 days (D2). The amount of morphine sulfate equivalents (MS eq) needed, the activity level, and adverse effects were recorded. Results: In Group A, the average pain score on D0, D1, and D2 was 2.7, 3.7, and 1.4, respectively; in Group B, the average pain score was 4, 4.5, and 2, respectively (P > 0.05). The average MS eq used in Groups A and B were 8.3 v 33.8 (P = 0.002) on D0; 17.7 v 28.7 (P > 0.05) on D1; and 11.1 v 10.1 (P > 0.05) on D2. On D0, in Group A, 56% of the patients were ambulating and 11% complained of nausea, while in Group B, 0 were ambulating and 46% complained of nausea. Conclusions: A single preoperative dose of subarachnoid spinal analgesia provides a statistically significant decrease in postoperative parenteral pain medication and earlier ambulation. It also appears to reduce the amount of postoperative pain and decrease nausea.

AB - Purpose: We studied the impact of one dose of subarachnoid spinal analgesia on postoperative pain and recovery after percutaneous nephrolithotomy (PCNL). Patients and Methods: Between August 1999 and May 2000, 20 PCNL patients were randomized into two groups: Group A (N = 9), who received preoperative subarachnoid spinal analgesia with morphine sulfate, and Group B (N = 11), who received no subarachnoid spinal analgesia. Both groups were given general anesthesia, and the nephrostomy site was infiltrated with bupivacaine hydrochloride. Stone size was similar in the two groups, as were ASA classification, age, and body mass index. Pain analog scales (maximum score 10) were completed preoperatively and on the day of surgery (D0), after 1 day (D1), and after 2 days (D2). The amount of morphine sulfate equivalents (MS eq) needed, the activity level, and adverse effects were recorded. Results: In Group A, the average pain score on D0, D1, and D2 was 2.7, 3.7, and 1.4, respectively; in Group B, the average pain score was 4, 4.5, and 2, respectively (P > 0.05). The average MS eq used in Groups A and B were 8.3 v 33.8 (P = 0.002) on D0; 17.7 v 28.7 (P > 0.05) on D1; and 11.1 v 10.1 (P > 0.05) on D2. On D0, in Group A, 56% of the patients were ambulating and 11% complained of nausea, while in Group B, 0 were ambulating and 46% complained of nausea. Conclusions: A single preoperative dose of subarachnoid spinal analgesia provides a statistically significant decrease in postoperative parenteral pain medication and earlier ambulation. It also appears to reduce the amount of postoperative pain and decrease nausea.

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