Analgesic efficacy of ultrasound guided paravertebral block in percutaneous nephrolithotomy patients: a randomized contr
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RESEARCH ARTICLE
Open Access
Analgesic efficacy of ultrasound guided paravertebral block in percutaneous nephrolithotomy patients: a randomized controlled clinical study Ferda Yaman1*
and Devrim Tuglu2
Abstract Background: Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, efficacious in operations performed. This study was undertaken to evaluate how efficacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN). Methods: A total of 44 patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects profile and the need for supplemental analgesia. Results: Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical significance in the PVB group compared to controls at 2 and 4 h post-surgery. At 6 and 8 h post-surgery, the control group had a lower VAS score when moving, and this result reached statistical significance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05). Conclusion: Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications. Trial registration: ClinicalTrials.gov, NCT04406012. Registered retrospectively, on 27 May 2020. Keywords: Ultrasound, Paravertebral block, Percutaneous nephrolithotomy
Background PCN (percutaneous nephrolithotomy) is a frequently employed, minimally invasive operative technique technique used to remove renal calculi [1]. The technique remains associated with significant demand for analgesic * Correspondence: [email protected]; [email protected] 1 Department of Anesthesiology and Reanimation, Faculty of Medicine, University of Eskişehir Osmangazi, 26040 Eskişehir, Turkey Full list of author information is available at the end of the article
interventions post-surgically. The application of regional anaesthesia is known to possess the highest efficacy in managing pain following surgery of this sort [2]. There are a number of methods available which may potentially reduce postoperative pain associated with nephrostomy tube placement in PCN, namely intercostal nervous blockade, epidural analgesia, peritubal infiltration of local anaesthetic and paravertebral blockade [3– 5]. Paravertabral blocks (PVB) are in use to adequately
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons At
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