Spinal and interpleural bupivacaine for percutaneous nephrolithotomy.

The promising interpleural block (IPB) technique stimulated the comparison of its adjuvant effect to spinal analgesia for percutaneous nephrolithotomy (PCNL) with that of meperidine-diazepam. Twenty five patients receiving spinal analgesia 15 mg 0.5% heavy bupivacaine for PCNL were randomly allocated to receive the adjuvant effect of either meperidine 1 mg/kg IV and diazepam 10 mg total dose (n = 10) or IPB with 10 ml 0.5% plain bupivacaine (n = 15). It was found that IPB produced a totally pain free operation and needed less frequent administration in the postoperative period, while meperidine-diazepam produced a pain free in 20% of patients and needed more frequent postoperative meperidine (1 mg/kg IM) administration.