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during PCNL; A few milliliters of nor-epinephrine is injected into the intended tract after puncture of pelvicalyceal system and before its dilatation compared to injection of saline (placebo). hemoglobin change & blood loss is estimated and will compared.
All patients of are positioned in lithotomy position and 6 F open tip ureteral catheter is fixed by cystoscope. Then, A pelvicalyceal system is punctured under ultrasound and/or fluoroscopic guidance, then a 18 Gauge (G) puncture needle is introduced toward the desired calyx and a 0.038 inch guide wire is inserted. then 20 G Chiba needle is introduced alongside the puncture needle for infiltration of the whole tract by either a few milliliters of nor-epinephrine or saline. then, the tract is dilated over the guide wire, lastly an Amplatz sheath was inserted.
nephroscope is used for stones disintegration by pneumatic or laser lithotripter . Fragments are washed out or removed by forceps.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Nor-Epinephrine (NE)-Group | Active Comparator | The PCNL tract is infiltrated by Nor-Epinephrine before its dilatation. |
|
| S-Group | Placebo Comparator | The PCNL tract is infiltrated by Normal Saline before its dilatation. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nor-Epinephrine injection versus saline during PCNL | Procedure | The PCNL tract is infiltrated by Nor-Epinephrine or Normal Saline before its dilatation. |
|
| Measure | Description | Time Frame |
|---|---|---|
| hemoglobin drop | the lower drop is better | 72 hours post intervention |
| blood loss | the lower loss is better | immediately after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| stone free rate | the higher is better | within 3 months post-operative |
| adverse events | the lower is better | within 30 days post-operative |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Waleed El-Shaer | Faculty of medicine, Banha university | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Banha University Hospitals | Banhā | Kalubiaya | 13518 | Egypt | ||
| Banha university hospital |
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| ID | Term |
|---|---|
| D016063 | Blood Loss, Surgical |
| ID | Term |
|---|---|
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007431 | Intraoperative Complications |
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double- blinded
| Banhā |
| Qalyubia Governorate |
| 13511 |
| Egypt |