Interpleural block was used in four patients undergoing percutaneous nephrostomy, one of whom also underwent percutaneous nephrolithotomy. Interpleural block was achieved with the standard technique using 30 ml of 0.5 per cent bupivacaine. All patients tolerated the procedure well and remained haemodynamically stable during the operative procedure. Mean pain relief from initiation of interpleural block was ten hours (SD = 4.32). Interpleural block was an effective method of obtaining anaesthesia for percutaneous nephrostomy and nephrolithotomy in these four patients.