Objective: To determine the efficacy and appropriate time of bupivacaine infiltration in the nephrostomy tract of tubeless
PCNL.
Material and Method: A randomized control study. 69 patients underwent tubeless PCNL between May 2014 and September 2015 at Siriraj Hospital, Mahidol University were enrolled in the study. They were randomized into three groups. Group A, patients had10 ml of 0.5% bupivacaine infiltrated in the access tract of PCNL after completed surgery. Group B,10 ml of 0.5%
bupivacaine was infiltrated before started the access. Group C, bupivacaine was not given. Pain score was evaluated using the visual analog scales (VAS)at immediate after the procedure, then every 4 hours until 24 hours.Postoperative morphine
requirement was recorded until 48 hours.
Results: Patient’s demographic data was similar among 3 groups. No difference of pain scores at any time after the
procedure. Morphine requirement, amount and time to first dose of post-operative morphine were not different among 3
groups.
Conclusion: Local anesthesia infiltration with 0.5% bupivacaine 10 ml at the access tract of tubeless PCNL does not reduce pain intensity and postoperative morphine requirement, neither before nor after the procedure.

Keywords: tubeless PCNL, nephrostomy tract infiltration, bupivacaine