Abstract
BackgroundParavertabral 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).MethodsA 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.ResultsVisual 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).ConclusionUltrasound-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 registrationClinicalTrials.gov, NCT04406012. Registered retrospectively, on 27 May 2020.
Highlights
Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis
PVB performed under ultrasonic guidance (PVB-US) targets the region of emergence of the spinal nerves through the foramina of the vertebrae
The groups did not differ at the level of statistical significance in terms of sex, age, weight, Body Mass Index (BMI) or classification under the Classification of American Society of Anesthesiologists (ASA) rubric (p > 0.05)
Summary
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, low risk and is efficacious in operations performed unilaterally. It rarely creates hypotension, urinary retention or nausea and vomiting following surgery [6]. PVB performed under ultrasonic guidance (PVB-US) targets the region of emergence of the spinal nerves through the foramina of the vertebrae. It blocks somatic and sympathetic fibres supplying several adjacent dermatomal segments both superior and inferior to where the injection is given [7]
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