Ultrasound-guided low thoracic paravertebral block versus peritubal infiltration for percutaneous nephrolithotomy: a prospective randomized study

AbstractThe aim of this study was to investigate the efficacy of peritubular infiltration and ultrasound-guided low thoracal paravertebral block in patients undergoing percutaneous nephrolithotomy (PCNL). Sixty patients, American Society of Anesthesiologists I –II, between the ages of 18 and 65 years undergoing PCNL were randomized into three groups. Group peritubal infiltration (Pi,n = 20) received infiltration along the nephrostomy tube 20 ml 0.25% bupivacaine, in 6 and 12 o’clock position. Group paravertebral block (Pv,n = 20) received single-shot paravertebral block with 20 ml 0.25% bupivacaine at the level of T8–T9. Group control (C,n = 20): no intervention is performed. Postoperative opioid consumption and pain scores, opioid-related side effects, and additional analgesic requirement were recorded. The fentanyl consumption in Group Pv was significantly lower in comparison to Group C in all time intervals (p <  0.05). In the comparison of Group Pv and Group Pi, fentanyl consumptions in the postoperative 0–4th hours (100.00 ± 50.65 and 145.00 ± 61.55, respectively), 4–8th hours (50.00 ± 64.88 and 121.25 ± 56.93 respectively), and in the total of 24 h (197.50 ± 133.74 and 3 68.75 ± 116.66 respectively) were significantly lower in Group Pv (p <  0.05). The dynamic VAS scores analyzed at the 1st and 2nd hours were significantly lower in Group Pv than Group Pi (p <  0.05). Eight patients in Group C...
Source: Urolithiasis - Category: Urology & Nephrology Source Type: research