Efficacy of Liposomal Bupivacaine for Pain Control After Percutaneous Nephrostolithotomy
Renal CalculiPostoperative PainPercutaneous nephrostolithotomy (PCNL) is a common endoscopic procedure performed for upper urinary tract calculus disease. Despite being minimally invasive, it is associated with significant postoperative pain, often necessitating inpatient hospitalization and narcotic pain medications. Additionally, one of a number of catheters is often left protruding from the access tract for a period of time following the procedure, adding to patient discomfort. Attempts have been made to study peri-tubular or access tract analgesic installation, which have shown promise.1-2 However, no studies, to our knowledge, have examined the use of liposomal bupivacaine preparations in this regard. In this study we hope to prospectively analyze the use of liposomal bupivacaine injected to the access tract site at the time of PCNL and determine its effects on postoperative narcotic requirement and pain scores. Patients presenting for PCNL will be randomized to either the liposomal bupivacaine or usual care, which involves no injection of local anesthesia. Patients will then be followed during their inpatient stay. Total narcotic requirement (in milligrams) and pain scores (using Wong-Baker FACES rating scale) will be compared.3 Typical postoperative care and discharge criteria will not change during the course of this study.
Pre-induction Analgesia: Multimodel Regimen vs Aceteminophen for Post Ureteroscopy Pain
Kidney CalculiPain1 moreAdult patients with kidney stones undergoing surgical intervention with ureteroscopy with laser lithotripsy will be randomized to receive one of two different regimens of oral medications administered prior to induction of general anesthesia. Postoperatively, patients will receive automated daily text messages to assess pain and opioid consumption and subsequently determine which which treatment regimen is superior.
Ultrasound First Clinical Decision Support for Suspected Nephrolithiasis
NephrolithiasisThis is a randomized trial to determine the effectiveness of a clinical decision support tool on image ordering for patients with suspected nephrolithiasis. Patients who present with acute unilateral flank or abdominal pain in whom emergency department providers suspect nephrolithiasis will receive either the clinical decision support tool or no tool (usual care).
Comparison of DASH With Oxalate Restricted Diet on Urine in Recurrent Stone Formers With Hyperoxaluria...
NephrolithiasisOxalate restricted diet is routinely prescribed in clinical practice of nephrolithiasis patients with hyperoxaluria. The effect of dietary oxalate on urinary oxalate is however controversial. Some studies do not implicate dietary oxalate as a major risk factor for nephrolithiasis. The Dietary Approaches to Stop Hypertension (DASH) diet, which is high in fruits and vegetables, moderate in low-fat dairy products, and low in animal protein represents a novel potential means of kidney stone prevention. The effect of a DASH-style diet on relative urinary supersaturations is however uncertain. Higher consumption of fruits and vegetables may increase urinary oxalate but also increases urinary citrate, an important inhibitor of calcium saturation.All the above data lead us to hypothesize that a DASH diet other than an oxalate restricted diet, which is routinely administered in clinical practice, might be beneficial in lowering urinary relative supersaturations of calcium oxalate in recurrent stone formers with hyperoxaluria. Recurrent stone formers with hyperoxaluria (urine oxalate>32.8) are allocated into 2 groups. The first group is prescribed an oxalate restricted diet. The second group are asked to follow a calorie-controlled DASH diet plan while drink water in the same amounts. 24-h urine is collected 2 times before study visits at baseline, 1 time on week 6 and 2 times at the end of the study.
Evaluation of the Performance of a Robotic Flexible Ureteroscopy (ILY) in Laser Treatment of Nephrolithiasis...
LithiasisUrinaryIn this pilot study, we wish to evaluate the performance of a robotic flexible ureteorscopy (ILY) in the treatment of nephrolithiasis in the superior excretory system
A Trial of Pyridoxamine to Lower Urine Oxalate in Subjects With Stone Disease or Hyperoxaluria
Kidney StonesTo determine whether pyridoxamine can decrease oxalate excretion in subjects who have normal oxalate excretion (but who have had kidney stones), and in subjects who have primary hyperoxaluria.
Perioperative Parameter and Treatment Outcomes of ECIRS in Asia
Renal StoneThis is an observational, international, multicenter, cohort study, prospectively collecting clinical data registry on consecutive patients with urinary stone undergoing ECIRS.
Serum Endotoxin Assay to Predict the Development of Postoperative Infectious Complications and Systemic...
NephrolithiasisUrosepsisThe aim of the study is to establish an infectious risk stratification system based on pre-and post-operative blood endotoxin profile.
Can Shear Wave Elastography Predict the Success of ESWL: a Prospective Study
Kidney StoneCan Shear Wave Elastography predict the success of Shock-Wave Lithotripsy used in renal stones treatment ? A prospective study
A Randomized Study of Whether Alfuzosin(Xatral) Helps in the Passage of Kidney Stones
Kidney StonesPatients who present for the first time to Emergency Room with renal colic due to a distal ureteral calculus (as diagnosed with spiral CT scan and KUB) will be randomized to receive Xatral 10mg po once a day or placebo once discharged from the ER. The purpose of this study is to assess if patients treated with Xatral will have a higher spontaneous passage rate of their ureteral stone than those treated with placebo.