Local anesthesia in percutaneous nephrostomy and trocar epicystostomy

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INTRODUCTION

In some cases, percutaneous nephrostomy (PNS) and trocar epicystostomy (TCS), which require adequate anesthesia, are used to restore the passage of urine. The choice of method, namely general or local anesthesia, depends on many factors, including the risks and complications of anesthetic care and should be made individually.

OBJECTIVE

To analyze the efficacy and safety of local anesthesia using articaine in PNS and TCS.

MATERIALS AND METHODS

The study included 85 patients aged 40—60 years who had undergone PNS or TCS. Positive allergic background, significant comorbidity, severe obesity, cicatrical changes in the area of operation were the exclusion criteria. Patients were divided into two groups depending on the type of anesthetic for local anesthesia. Specifically, 2% Articaine-Binergia — 2 ml diluted in 10 ml of 0.9% saline solution was used in the first group of 48 (40 PNS and 8 TCS) humans, and 2% Lidocaine — 2 ml in the same dilution was used in the second group of 37 (30 PNS and 7 TCS) subjects.

RESULTS

The articaine group has been considerably superior to the lidocaine one on all indicators in the clinical evaluation of anesthesia’s efficacy in scores. A better safety profile has been noted by symptoms of allergic reaction, tissue neurotoxicity, formation of hematomas and infiltration of the injection site in the analysis of adverse events (complications) in the articaine group.

CONCLUSIONS

The conducted study on the use of Articaine-Binergia in urological interventions requiring local anesthesia, in particular such as PNS and TCS, showed that Articaine-Binergia exceeded lidocaine in analgesic effect and safety profile, and, importantly, saving in anesthetic’s use due to the lower total volume of administration has been noted.

Keywords:

percutaneous nephrostomy

trocar epicystostomy

local anesthesia

articaine-binergia

Authors:

Feofilov I.V.

Novosibirsk State Medical University;
Novosibirsk Regional Clinical Hospital

ORCID: 0000-0001-8938-2479

Received:

23.09.2024

Accepted:

15.10.2024

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