Postoperative Analgesic effect of Quadratus Lumborum Block III versus Peritubal Local Infiltration in patients undergoing Percutaneous Nephrolithotomy surgery

Abstract

The first patient to undergo Percutaneous Nephrolithotomy (PCNL) for treatment of kidney stone was in 1976. Since then, this technique has had constant evolution, which increase its success rate. Also usage of open Nephrolithotomy has been reduced to very minimal rates and (PCNL) has become the 1st choice of treatment for stag horn and other large renal stones (>2 cm in maximum diameter). Despite the safety of PCNL, like any other procedure, it has its own complications as injury to related organs, hemorrhage and pain. Surgical stress is accompanied by pain, immune-dysfunction, nausea/vomiting, ileus, increases cardiac demands, sleep disturbance and fatigue. Also post operative pain can cause prolonged length of stay in hospitals and increased recovery period. However, despite an explosion in our knowledge of the pathophysiology of acute pain, the development of a few new analgesics, methods of drug delivery, and implementation of pain reducing minimal invasive surgical techniques, acute postoperative pain management remains a huge challenge for optimization. The postoperative pain of PCNL can be managed by several techniques; Epidural anesthesia has an advantage over