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Background and Aims This prospective study aimed to evaluate regional tract analgesia (RTA) using ropivacaine to manage postoperative pain for patients undergoing percutaneous nephrolithotomy in prone position (PCNL).

Methods The patients were stratified into 4 groups based on the utilized analgetic regimen: The ordinary group including the intravenous use of paracetamol and tramadol, the paracetamol pump group, the tramadol pump group and the RTA group using 2% ropivacaine. The primary endpoints of this study were the time needed to achieve maximum analgesia and the comparison of the efficacy. All the patients were evaluated every 6 hours postoperatively until the completion of 24 hours. The pain assessment was conducted with the use of the Numerical Rating Scale (NRS) 0-10 score.

Results A total of 80 patients who underwent PCNL were divided into 4 groups of 20 patients each. The RTA was superior to the ordinary analgesic regimen and to the paracetamol tract in all the postoperative evaluations (6,12,18,24 hours) regarding the efficacy in pain relief. The differences between RTA and tramadol pump groups were not statistically significant. Moreover, in terms of time needed to achieve the maximum analgesia, the difference between the ordinary regimen and RTA groups was statistically significant (15,6±4,92 hours vs 21,6±4,08 hours, p=0,013)

Conclusions The use of regional tract analgesia seems to be a more efficient and faster method compared to the ordinary analgesic regimen and paracetamol pump. It was also proved that it is not inferior to the tramadol pump avoiding the adverse effects of tramadol.