Spinal and interpleural bupivacaine for percutaneous nephrolithotomy

The promising interpleural block [IPB] technique stimulated the comparison of its adjuvant effect to spinal analgesia for percutaneous nephrolithotomy [PCNL] with that of meperidine-diazepam. Twenty five patients receiving spinal analgesia 15 mg 0.5% heavy bupivacaine for PCNL were randomly allocated to receive the adjuvant effect of either meperidine 1 mg/kg IV and diazeparn 10 mg total dose [n = 10] or IPB with 10 ml 0.5% plain bupivacaine [n = 15]. It was found that IPB produced a totally pain free operation and needed less frequent administration in the postoperative period, while meperidine-diazepam produced a pain free in 20% of patients and needed more frequent postoperative meperidine [1 mg/kg IM] administration