Evidence-Based Pain Management and Rehabilitation Nursing is Associated With Reduced Early Postoperative Biochemical Stress Markers and Improved Recovery After Mini-PCNL for Complex Renal or Ureteral Stones: A Retrospective Cohort Study.

OBJECTIVE

To evaluate whether an evidence-based pain management and rehabilitation nursing pathway improves early recovery after mini-percutaneous nephrolithotomy (mini-PCNL) for complex renal or ureteral stones.

METHODS

This retrospective cohort study included 148 patients undergoing mini-PCNL from January 2023 to December 2025. The control group received routine perioperative nursing care (January 2023-June 2024), and the observation group received an evidence-based pain and rehabilitation nursing pathway (July 2024-December 2025), with 74 patients in each group. Stress indicators, pain, renal function, recovery milestones, and complications were compared.

RESULTS

Heart rate and mean arterial pressure changed over time, but did not differ between-group. Compared with the control group, the observation group had lower cortisol levels at 6 h (888.5 ± 159.3 vs 1074.1 ± 258.2 nmol/L) and 24 h postoperatively (522.7 ± 97.5 vs 868.0 ± 215.9 nmol/L), and lower adrenocorticotropic hormone levels at 6 h (20.7 ± 5.4 vs 26.9 ± 7.6 pmol/L) and 24 h postoperatively (12.6 ± 3.5 vs 21.4 ± 6.2 pmol/L). Median Visual Analogue Scale (VAS) pain scores were lower at 6, 12, and 24 h postoperatively (5, 4, 3 vs 7, 6, 5). At 24 h postoperatively, serum creatinine (87.5 ± 14.7 vs 96.4 ± 15.0 µmol/L) and blood urea nitrogen levels (5.59 ± 0.94 vs 6.36 ± 1.34 mmol/L) were lower. The observation group also had earlier first ambulation (13.3 vs 15.4 h), lower VAS scores at first voiding (3 vs 5), and shorter hospital stay (4 vs 6 days). Nephrostomy tube duration, catheter duration, urinary tract infection, and haematuria were similar.

CONCLUSIONS

Evidence-based pain management and rehabilitation nursing was associated with reduced early biochemical stress markers, improved pain control and short-term renal function, and accelerated early recovery after mini-PCNL.