Percutaneous nephrolithotomy(PCNL) is a common and less invasive method for management of renal calculi. However, it still causes significant postoperative pain demanding good analgesia. Intercostal nerve block(INB) and peritubal infiltration of the nephrostomy tract are well established form of regional anesthesia and their efficacy in alleviating the pain after PCNL has been well documented. In our present study we compared the efficacy ofINB to peritubal infiltration in providing superior postoperative analgesia in PCNL

A prospective double blinded, randomized study was designedin 50 ASA-1 and IIpatients who weredivided in to two groups. Group-P received peritubal infiltration with15 ml of 0.25% Ropivacaine using 23G spinal needle along the nephrostomy tract at “6 and 12” O clock position. Group-Ireceive intercostal nerve block in 10, 11, 12th spaces with 0.25% Ropivacaine 5ml in each space.Both the techniques were performed under fluoroscopy at the end of procedure. Patients were followed up for 24hrs postoperatively for pain by visual analog scale(VAS) and Dynamic VAS.Rescue analgesia was inj.tramadol 100mgIVwhen pain scores exceeded 4 tomaximumof 300mg in 24hours.Time to first rescue analgesic,number of doses and total tramadol required were noted.

Pain scores were low in both the groups but the mean time to first rescue analgesia was significantly more in G I (p-0.001).Mean number of demands and the amount of analgesia consumed were also less in Group-I

Intercostal nerve block is more efficient postoperative analgesic interventionthan peritubal infiltration in PCNL.