{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:33:42Z","timestamp":1786649622032,"version":"build-2736575974"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Postoperative pain is a significant concern following percutaneous nephrolithotomy (PCNL). While tubeless PCNL has reduced discomfort, effective and simple analgesic techniques are still needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A double-blind, randomized controlled trial was conducted at two tertiary hospitals with 120 adult patients having solitary renal pelvic stones &lt;3 cm. Patients were randomized into two groups: the intervention group received 20 mL of 0.25% bupivacaine infiltrated into the tract at surgery end, and the control group received no infiltration. Postoperative pain was assessed using the visual analog scale (VAS) at 6, 12, and 24 h. Both patients and outcome assessors were blinded. Data from 57 intervention and 56 control patients were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Baseline demographic, anatomical, and perioperative characteristics were well-matched between the two groups (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). Repeated-measures analysis of variance revealed a significant main effect for both time (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and treatment group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.006). The bupivacaine group consistently reported significantly lower mean VAS pain scores at 6 h (4.33 \u00b1 0.97 vs. 4.85 \u00b1 1.05,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.008), 12 h (2.68 \u00b1 0.81 vs. 3.16 \u00b1 0.95,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.005), and 24 h (1.53 \u00b1 0.68 vs. 1.84 \u00b1 0.71,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.018) than the control group postoperatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Infiltration of the nephrostomy tract with 0.25% bupivacaine is a simple and effective method for significantly reducing postoperative pain at 6, 12, and 24 h after tubeless PCNL. This technique provides a sustained analgesic benefit and should be considered for routine implementation to enhance patient recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jrms.jrms_963_25","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T13:00:10Z","timestamp":1767099610000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The efficacy of 0.25% bupivacaine infiltration in tubeless percutaneous nephrolithotomy in singular stone of the pelvis: A randomized clinical trial"],"prefix":"10.4103","volume":"30","author":[{"given":"Reza","family":"Kazemi","sequence":"first","affiliation":[{"name":"Department of Urology, Isfahan University of Medical Sciences, Isfahan, Iran"},{"name":"Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamidreza Moein","family":"Najafabadi","sequence":"additional","affiliation":[{"name":"Department of Urology, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrdad","family":"Norouzi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir Hossein","family":"Ghandehari","sequence":"additional","affiliation":[{"name":"School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12]]},"reference":[{"key":"R1-20251230","first-page":"333","article-title":"Urolithiasis: History, epidemiology, aetiologic factors and 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