Intra-Pyelocaliceal Dexamethasone Injection for Postoperative Pain Management in Ureteroscopic Lithotripsy: A Triple-Blinded Randomized Clinical Trial

Introduction: Ureteroscopic lithotripsy commonly causes postoperative pain. The local use of corticosteroids to reduce this pain remains unclear. This triple-blind randomized clinical trial evaluated whether an intra-pyelocaliceal injection of dexamethasone reduces postoperative pain, analgesic requirements, and other clinical outcomes after Ureteroscopy (URS).Methods: From September ۲۰۲۳ to October ۲۰۲۴, ۸۴ patients with ureteral stones requiring URS were randomized (۴۲ per arm) to receive intra-pyelocaliceal dexamethasone (۲mL, ۸mg) or distilled water (۲mL) before double-J stent placement. One control participant withdrew consent, leaving ۴۲ dexamethasone and ۴۱ control participants. Postoperative analgesics were administered as needed. Demographic, operative, analgesic-consumption, and vital-sign data were collected until the patients were discharged from the hospital. Statistical analysis was performed using SPSS v۱۹ with significance set at P-value<۰.۰۵.Results: Baseline characteristics including sex distribution, comorbidities, history of lithotripsy, stone laterality, stone size, and age were similar between groups (P-value>۰.۰۵). The frequency of administered doses of paracetamol, pethidine, and diclofenac, and total analgesic requirements, were not significantly different between groups (P-value>۰.۰۵). No significant differences were observed in operative time, length of hospital stay or postoperative vital signs, including body temperature, and blood pressure between groups (P-value ۰.۰۵).Conclusion: Injection of dexamethasone into the pyelocaliceal space during URS did not significantly reduce postoperative analgesic requirements or alter clinical outcomes including vital signs, operative time, or hospital stay duration.

کلیدواژه ها:

corticosteroids ، Lithotripsy ، Postoperative pain ، Ureteral Calculi ، urolithiasis