Comparison between Ultrasound Guided Peritubular Infiltration and Paravertebral Block for Postoperative Pain Relief in Percutaneous Nephrolithotomy

Abstract

Background: Percutaneous Nephrolithotomy is most advanced and preferred technique for Renal calculi but associated with pain and discomfort in postoperative period. Aim of our study is to compare analgesic efficacy of peritubular infiltration with paravertebral block under Ultrasound guidance for postoperative pain relief. Methods: In this prospective randomised study total 60 adult patients were allocated in two equal groups (A, B). After undergoing surgery under general anaesthesia group A patients received peritubular infiltration of 15ml of 0.25% inj.bupivacaine with inj. Dexmeditomidine 1ug/kg and group B patients received 15ml of 0.25% inj.bupivacaine with inj. Dexmeditomidine 1ug/kg in Paravertebral space T11, T12, L1 under ultrasound guidance. Postoperatively hemodynamic variables, VAS, Dynamic VAS, mean time for 1st demand of analgesia and total consumption of inj.tramadol were noted in both groups. Results: At 4, 8, 12 hrs VAS, Dynamic VAS scores were lower in group B compared to group A(p<0.005). Hemodynamic variables were comparable between groupsand demand for first rescue analgesia time were higher in paravertebral block group compared to peritubular infiltration group and total consumption of tramadol were low in paravertebral block. Conclusion: Paravertebral block under ultrasound guidance is an effective analgesia for PCNL in postoperative period compared to peritubular infiltration.