In Terms of Analgesic Requirements — A Comparison Between Laparoscopic Nephrectomy and Open Nephrectomy

Objective: In this study, we aimed at making a comparison between the laparoscopic nephrectomy and open nephrectomy in terms of post-operative pain and pethidine consumption. Methods: The study has been designed with patients who underwent prospective and randomized laparoscopic and open nephrectomy operation. We assessed the post-operative pain through visual analogue scale (VAS) at the 0st, 2nd, 4th, 8th, 12th, 18th, and 24th post-operative hours. We carefully recorded the intraoperative and post-operative results along with the post-operative pain-relieving analgesic doses. Results: A total number of 30 patients were included in this study. The VAS scores of the two groups did not demonstrate a significant difference, but the analgesic (Pethidine) requirement was significantly lower in the laparoscopic group (p=0.031). The groups demonstrated no difference in terms of adverse effects. Conclusion: Along with similar perioperative results, laparoscopic nephrectomy offers an advantage in case of post-operative pain with regard to analgesic requirement and hospital stay duration. 1. Associate Professor, Department of Urology, National Institute of Kidney diseases and Urology (NIKDU), Dhaka 2. Associate Professor, Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. 3. Professor, Department of Physiology, Uttara Adhunik Medical College, Dhaka 4. Associate Professor, Department of Urology, Patuakhali Medical College, Patuakhali 5. Assistant Professor & RS, Department of Urology, National Institute of Kidney diseases and Urology (NIKDU), Dhaka Correspondence: Dr.Abdul Matin Anamur Rashid Choudhury, Associate Professor, Department of Urology, National Institute of Kidney diseases and Urology (NIKDU), Dhaka, Bangladesh. E-mail: dr_choudhury2001@yahoo.com Introduction: Endourological interventions have replaced many classical surgical intervention methods. The most important reason for the preference of these surgical intervention methods by surgeons lies in their advantage of being minimally invasive. In this respect, ureterorenoscopic, percutaneous renoscopic and laparoscopic treatment approaches are the most preferred treatment methods in today’s urology. However, classical surgery remains as the best alternative in some indications. In general, subcostal flank incision is used in open surgical approaches employed for upper urinary system. This approach offers the surgeon a wide operative field. However, according to the general consensus, it requires a considerable amount of muscle cutting, and leads to more post-operative pain and longer recovery period. Since it leads to pain, secretion of the potent mediators of inflammation, and tissue trauma, surgery might be considered as an injury.1 Consequently, post-operative pain may be present in an expected case, but it is not expected to be the same in all surgical procedures.2