Effect of Preoperative Single-Dose Methylprednisolone Administration on Early Postoperative Pain Following Retrograde Intrarenal Surgery

Abstract

Abstract Aim:To evaluate the effect of preoperative single-dose methylprednisolone use on postoperative early pain after retrograde intrarenal surgery (RIRS). Material and Metod: Patients who had a 10–20 mm solitary kidney stones and underwent RIRS procedures were included in this prospective cohort study between February 2022 and May 2023. Patients who were administered methylprednisolone at a dose of 1mg/kg preoperatively were included in group 1 (n: 31), and the other first 90 patients who met the inclusion criteria and did not receive methylprednisolone before surgery were included in group 2 (n:90). Demografic data, features of stone, postoperative pain at 1, 6, 12, 18, and 24 hours, the need for analgesics, changes of serum glucose levels and, the prevalence of postoperative fever were compared. Results: Age, sex, stone laterality, localization, size, and Hounsfield Unit, modified Satava scores, stone-free status, duration of the RIRS procedure, and duration of the Ureteral Access Sheath were found to be similar between groups. VAS scores at postoperative 1, 6, 12, 18, and 24 hours were found to be statistically significantly lower in gourp 1 (p=.001, p=.001, p=.001, p=.001 and p=.001, respectively). Similarly, postoperative analgesic requirements were found to be significantly lower in group 1 (p=.048) with a similar postoperative fever rate and changes of serum glucose levels between groups. Conclusion: Giving a single dose of metylprednisolone at a dose of 1mg/kg preoperatively during the RIRS procedure is safe and effective at preventing early pain and the need for analgesics after the RIRS procedure.