Prophylactic tramadol versus nefopam for post-operative catheter -related bladder discomfort in patients undergoing elective per-cutaneous nephrolithotomy

INTERVENTION: 3 groups are included in which a total volume of 10 ml. Isotonic saline ( 0.9%) are given slow intravenously (Over 1 min.) 30 min. Before expected extubation Group I: tramadol group received 1.5 mg/kg tramadol diluted in 10 ml. Isotonic saline ( 1 min. Duration) Group II: nefopam group received 0.15 mg/kg nefopam diluted in 10 ml.isotonic saline(1 min. duration) Group III: control group received isotonic saline 10 ml. (1min. duration). CONDITION: Anaesthesiology ‐ Pain management Pain management; ; Pain management Renal and Urogenital ‐ Other renal and urogenital disorders PRIMARY OUTCOME: ; Occurrence of catheter ‐ related bladder discomfort; Which is being assessed by using a 4‐ point scale .[‐Immediately after extubation (0 hr.).; ‐Thereafter at 1, 2 and 6 hours after operation ( primary time point).; ; ] SECONDARY OUTCOME: ‐ Duration of effective post‐ operative analgesia, which is being assessed by using visual analogue scale( VAS). ; ‐Effective: means the interval ( time period) between extubation and administration of 1 st rescue analgesic dose . ; ‐The test used to determine this secondary outcome is visual analogue score .[‐Immediately after extubation( 0 hr.). ; ‐Thereafter at 1,2 and 6 hours after operation( secondary time point).] INCLUSION CRITERIA: adult patients of either sex, ASA I or II, undergoing per cutaneous nephrolithotomy(PCNL) for renal upper ureteric stone requiring catheterization of urinary bladder . This procedure usually requires postoperative bladder drainage for 12‐24 hours in addition to nephrostomy .