Current advances in pain regimens for percutaneous nephrolithotomy A comprehensive review.

Tomas Paneque, John Richey, Ahmad Abdelrazek, Kevin Morgan, Joseph Fitz-Gerald, Seth Swinney, Zachary M Connelly, Nazih Khater
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Abstract

Introduction: Percutaneous nephrolithotomy (PCNL) causes pain and discomfort after surgery. The primary causes of immediate postoperative pain after PCNL are visceral pain from the ureters and kidneys, and body surface discomfort from incisions. Acute, untreated pain has the potential to develop into chronic pain, which remains a considerable burden for the rehabilitation of patients. The goal of this review was to describe the current options for treating pain post-PCNL.

Methods: We conducted a literature review of all published manuscripts on pain protocols for patients undergoing PCNL and related topics; 50 published manuscripts were identified and reviewed.

Results: PCNL morbidity must be reduced by an appropriate management of postoperative pain. Opioids, multimodal therapy, tubeless PCNL, reduced size of nephrostomy tube, and regional anesthesia are currently available for reducing postoperative pain.

Conclusions: Implementing successful treatment strategies for postoperative pain after PCNL is key in reducing the morbidity and mortality of PCNL.

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经皮肾镜取石术疼痛治疗的最新进展综述。
导读:经皮肾镜取石术(PCNL)术后会引起疼痛和不适。PCNL术后即刻疼痛的主要原因是输尿管和肾脏的内脏疼痛,以及切口引起的体表不适。急性,未经治疗的疼痛有可能发展成慢性疼痛,这仍然是患者康复的一个相当大的负担。本综述的目的是描述目前治疗pcnl后疼痛的选择。方法:我们对所有已发表的关于PCNL患者疼痛方案和相关主题的文献进行了综述;鉴定并审查了50篇已发表的手稿。结果:PCNL的发病率必须通过适当的术后疼痛管理来降低。目前,阿片类药物、多模式治疗、无管PCNL、缩小肾造口管尺寸和区域麻醉可用于减轻术后疼痛。结论:实施成功的PCNL术后疼痛治疗策略是降低PCNL发病率和死亡率的关键。
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