# Use of Baclofen Premedication as an Analgesic Adjuvant in Patients Undergoing Percutaneous Nephrolithotripsy: A Placebo-Controlled, Double-Blind Randomized Trial

## TL;DR

A study tested if baclofen, a muscle relaxant, could reduce pain and opioid use after kidney stone surgery but found no significant benefits.

## Contribution

This is the first placebo-controlled trial examining baclofen's preoperative analgesic effects in percutaneous nephrolithotomy patients.

## Key findings

- Baclofen did not significantly reduce postoperative opioid use compared to placebo.
- Patients with prior opioid use had higher postoperative opioid consumption.
- Baclofen was safe with no differences in side effects or vital signs.

## Abstract

Introduction: Baclofen, a clinically available GABAB receptor agonist, produces nonopioid analgesia in multiple models of pain but has had limited studies related to perioperative pain control. The present study seeks to study effects of baclofen on postoperative pain measures and opioid use in adult patients subjected to percutaneous nephrolithotomy (PCNL).

Methods: Using a placebo-controlled, double-blind methodology, a single 10 mg oral dose of baclofen or placebo was given prior to a surgery in 34 patients undergoing PCNL. Standardized intraoperative and postoperative protocols related to opioid use were followed. Use of postoperative opioids in the post-anesthesia care unit and for the first 24 hours following surgery were recorded as were pain scores and other medication use.

Results: There was a significant positive correlation in the use of postoperative opioids in patients who had a preceding history of opioid use. However, there were no significant differences in opioid use which could be attributed to baclofen. There were also no differences in postoperative vital signs, side effects or other medication use.

Conclusions: Analgesic benefits of preoperative baclofen were not observed at the dose employed. Safety of the drug was observed.