Assessment of Post Operative Pain Management in Open Suprapubic Cystolithotomy for Bladder Stone: An Observational Study

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Abstract (English)

Aim: The aim of the present study was to record the drug used for postoperative pain in suprapubic cystolithotomy
and to determine the effectiveness of multimodal analgesics used.
Material & Methods: A prospective observational study for a period of 12 months in 100 patients who underwent
suprapubic cystolithotomy from the department of general surgery
Results: A total of 100 patients were included among which 40 were female and 60 were the male patients. The
patients who underwent suprapubic cystolithotomy were aged between 20 and 70.40 patients were in the age
group of 40-50 years. The 20 different types of surgeries were recorded. The most common surgery performed in
our study was open appendectomy followed by open cholecystectomy. Four different types of anaesthesia were
used. Most common was general anaesthesia with transverse plane block followed by general anaesthesia with
quadratus lumborum block. Most common mode of analgesia used was combined analgesia. Injection tramadol
50 mg in 100 ml normal saline with continuous epidural bupivacaine followed by injection diclofenac AQ 75 mg
in 100 ml N.S with continuous epidural. By the second day 52 patients were shifted to oral analgesics most
common drug used was the combination of aceclofenac, paracetamol and serratiopeptidase. NRS score was
recorded for all the 100 patients on postoperative days 1, 2 and 3. Severity of pain gradually reduced from post -
operative days 1-3 with the use of various analgesics.
Conclusion: Combined analgesia was better mode of pain management method than a single analgesic. Due to
different multimodal analgesics used in different institutions patients experienced different degrees of pain, hence
we need a standard protocol for a best pain management method.