Abstract

Percutaneous nephrolithotomy (PCNL) is a standard procedure to remove and disintegrate large kidney stones. Despite minimal invasiveness, it is associated with significant postoperative pain. Erector spinae plane block (ESPB) is a novel interfacial plane block recently introduced to provide analgesia in acute and chronic pain. The current study was conducted to compare the efficacy of ultrasound (USG) guided ESPB and conventional analgesia (CA) following PCNL. Methodology: After obtaining the institute's ethical committee approval and informed consent, 50 patients were included in the study and were randomized into two equal groups of 25 to receive ESPB with 20 ml of 0.25% bupivacaine or CA. Patients in both groups were given intravenous paracetamol 8th hourly and intravenous tramadol 2mg/kg as rescue analgesia. Results: Both study and control groups were similar in demographic profile. Pain assessment by Visual analogue scale (VAS) scores in the postoperative period were significantly lower at hours of 20min,40min, and 1,3,6,12 hrs (P<0.0001) and at 9,18 hrs (P<0.05) in the group E, than the control group. The time to first rescue analgesia was observed longer in the ESPB group than in the control group (2.28± 0.58hrs Vs 15.48± 3.17 hrs ) (P<0.0001). The average tramadol consumption was less in the ESPB group compared to the control group (139.28±41.36 mg Vs 337.20± 38.66mg) (P< 0.0001). Conclusion: Ultrasound-guided ESPB provides safe and effective postoperative analgesia following PCNL, with decreased VAS scores. ESPB extends the retrieval analgesia time and lessen the requirement for tramadol.

Description