{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:17:36Z","timestamp":1747185456155,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T00:00:00Z","timestamp":1662940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To determine the efficacy and safety of trajectory infiltration with 1:150\u2009000 Norepinephrine (NE) in reducing blood loss during percutaneous nephrolithotomy (PCNL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>This is a prospective randomized double\u2010blinded placebo\u2010controlled trial. In all, 140 consecutive patients underwent PCNL for the management of large renal calculi. They were randomly assigned (1:1) to one of either study groups, the NE\u2010PCNL group (70 patients whose PCNL\u2010trajectory was infiltrated by NE) or the Placebo group (saline PCNL) (70 patients whose PCNL tracts were infiltrated by normal saline). Procedure\u2010related blood loss (the primary outcome) was assessed and statistically analyzed. Also, all other procedure\u2010related events and complications were recorded and compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median blood loss was 378\u2009ml (IQR: 252\u2013504) in the NE\u2010PCNL group versus 592\u2009ml (IQR: 378\u2013756) in the S\u2010PCNL group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). In addition, Hemoglobin and Hematocrit deficits were lower in NE\u2010PCNL (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Patients who were randomized to the NE\u2010PCNL group had a higher immediate stone\u2010free rate (SFR) (80%) compared with those of the S\u2010PCNL group (70%) (<jats:italic>p<\/jats:italic>\u2009=\u20090.034). However, no statistical differences were found in the final SFR. The reported overall complications between the 2 groups were similar (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Indeed, bleeding\u2010related complications were 1 (1.4%) versus 10 (14.3%) for NE\u2010PCNL and S\u2010PCNL, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.009).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Trajectory infiltration of PCNL tracts by NE was found to be effective and safe in mitigation of PCNL\u2010related blood loss. This step is a timeless and cost\u2010effective as NE is readily available in surgical theaters and of very low cost.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.15036","type":"journal-article","created":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T15:48:26Z","timestamp":1662997706000},"page":"1535-1542","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Can trajectory nor\u2010epinephrine infiltration reduce blood loss during percutaneous nephrolithotomy? 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