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The Efficacy of Erector Spinae Plane Block for Patients Undergoing Percutaneous Nephrolithotomy

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Specialty Anesthesiology
Date 2023 Jul 17
PMID 37455435
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Abstract

Objective: Percutaneous nephrolithotomy (PCNL) is accompanied by somatic and visceral pain intraoperatively and postoperatively. However, pain management strategies lack a decisive consensus. Erector spinae plane block (ESPB) is a novel paraspinal fascial block that can be used in PCNL patients, and we aimed to investigate whether ESPB will reduce intraoperative and postoperative opioid consumption and postoperative pain scores in PCNL patients.

Methods: The study was randomized, controlled, and open-label. Two groups were formed as the control group (GCont) and block group (Gblock), and patients received total intravenous anaesthesia. GBlock received an ESPB catheter in addition in the prone position. Intraoperative parameters and infusion doses, postoperative rescue analgesic doses, and pain scores were recorded. The primary endpoint was intraoperative analgesic consumption, and the secondary endpoints were postoperative pain scores and analgesic consumption.

Results: Sixty-four patients were analyzed. Remifentanil consumption of GCont was found to be significantly higher (GBlock: 0.0865 ± 0.030 vs GCont: 0.1398 ± 0.034, μg kg min, < 0.001). The control group reported higher pain scores between the 30 min and 24 hours and needed more analgesics between the 1 and 6 hours postoperatively. GBlock received local anaesthetics via ESPB catheter before nephrostomy tube removal and fewer patients needed analgesics [5 patients (15.6%) vs. 28 patients (87.5%), < 0.001]. GCont consumed more tramadol postoperatively (262.5 mg vs. 75 mg, < 0.001).

Conclusion: We found that ESPB reduced intraoperative opioid consumption. It also reduced the need for rescue analgesia and postoperative pain scores during nephrostomy tube removal. We concluded that the ESPB catheter may effectively be used in analgesia management during and after PCNL operations.

Citing Articles

Effect of different regional anaesthesia techniques on postoperative analgesia following percutaneous nephrolithotomy: A systematic review and network meta-analysis.

Long K, Zhou C, Liang J, Tang X, Li Z, Chen Q Indian J Anaesth. 2025; 69(1):12-22.

PMID: 40046708 PMC: 11878359. DOI: 10.4103/ija.ija_679_24.


Efficacy of erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized controlled trials.

Singh A, Sharma A, Ganesh V, Gupta R, Sharma G, Naik N J Anaesthesiol Clin Pharmacol. 2025; 41(1):62-72.

PMID: 40026740 PMC: 11867357. DOI: 10.4103/joacp.joacp_403_23.

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