To explore feasibility and safety of minimally invasive percutaneous nephrolithotomy (MPCNL) under intercostal nerve block combined with local anesthesia.

From October 2018 to November 2019, under the guidance of ultrasound, intercostal nerve blocks were performed at the intersection of the 10th, 11th, and 12th ribs of the affected side with the spine. 5 ml of 0.5% bupivacaine (containing 1/1 000 epinephrine) was injected at each site, and then local infiltration anesthesia on the selected puncture channel (2% lidocaine 10 ml + normal saline 15 ml mixed solution about 10 ml) was performed. Ultrasound guided puncture and one-step expansion of MPCNL was implemented, visual analogue scale (VAS) was used to assess pain severity.

The operations were successfully completed in 38 cases, no one needed to change the method of anesthesia, no serious complications occurred, and no case was converted to open surgery. The mean VAS scores during surgery and after 2 h, 4 h, and 24 h were 2.6, 2.2, 1.8, and 1.3 points respectively, the overall stone removal rate at 9 weeks was 91.3% (21/23).

Selecting suitable cases, MPCNL under intercostal nerve block combined with local anesthesia is simple, safe and efficient.