A Study on Post Operative Pain Assesment on Arrival Using Vas Score among Urological Procedures after general Anaesthesia vs. Regional Anaesthesia

Background: A Visual Analogue Scale (VAS) is a measurement that tries to measure a characteristic or attitude that is believed to range across a continuum of values and cannot easily be directly measured [1]. The 100 mm visual analogue scale (VAS) score is widely used to measure pain intensity after surgery. The main objective here is to compare the effectiveness and safety of general anaesthesia (GA) vs. regional anaesthesia (RA) in urological procedures with the help of VAS.

Methods: We enrolled a sequential, unselected cohort of fifty-two patients on arrival from surgery and used a VAS to quantify pain intensity. We compared changes in the VAS among patients who received either GA or RA for urological procedures. Patient’s comorbidities, vitals, pain visual analogue scale (VAS) are evaluated. Intraoperative and post-operative complications were recorded.

Results: Vital parameters were maintained at safe values throughout the procedure in both groups. Visual analogue pain score was lower in regional anaesthesia till one hour mark of post-operative period as compared with GA cluster (P <0.05). Patients in regional anaesthesia recorded lower consumption of analgesics during the post-operative day-0 as compared with GA cluster (P < 0.05). Post-operative shivering was higher in RA cluster than GA cluster (8% vs. 2%) whereas nausea and fever was higher in GA cluster than RA cluster (5% vs. 2% and 4% vs. 1% respectively). However, Patients in GA cluster recorded higher overall satisfaction scores than RA cluster.

Conclusion: Both GA and RA were effective and safe in Percutaneous Nephrolithotomy. It is observed that PCNL under RA was associated with significantly shorter operative time and hospital stay. Furthermore, postoperative pain scores were low, lower nausea and/or vomiting, and reduced analgesic requirements were noted in the RA group. However, GA provides heaps of satisfaction for patients.