Comparison of erector spinae plane block and local anaesthetic infiltration of the incision site for postoperative analgesia in percutaneous nephrolithotomy – A randomised parallel-group study

Ramachandran, Srinivasan; Ramaraj, Krishna Prabu; Velayudhan, Savitri; Shanmugam, Balasubramanian; Kuppusamy, Sureshkumar; Lazarus, Suneeth P.

doi:10.4103/ija.ija_1450_20

Cited by 13 publications

(20 citation statements)

References 31 publications

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“…In our study, the first demand for analgesics was earlier in group C than in group E. In a study by Lomate et al, the ESP group had a longer period before their first demand for analgesics than the peritubular infiltration block group (p < 0.001) [ 11 ]. Similarly, Srinivasan et al examined the time before the first demand for analgesics in ESP and local infiltration groups in patients undergoing PCNL surgery and found a significantly (p < 0.001) prolonged duration of analgesia in the ESP group [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Ultrasound-Guided Erector Spinae Plane Block in Percutaneous Nephrolithotomy

Pandey¹,

Yadav²,

Khan³

et al. 2023

Cureus

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BackgroundPercutaneous nephrolithotomy (PCNL) is presently the preferred method for managing renal calculi. Visceral pain from the kidney and ureter and somatic pain from the incision site are the primary causes of immediate postoperative pain following PCNL. Poor pain control is associated with unwanted consequences such as patient discomfort, delayed recovery, and prolonged hospital stay. Recently, the erector spinae plane (ESP) block has been used in many thoracic and abdominal surgeries for the control of postoperative pain. In this study, we aimed to assess the effectiveness of the ultrasound-guided ESP block following PCNL. MethodologyThis was a prospective, double-blind, randomized controlled study including 60 patients who were scheduled for elective PCNL under general anesthesia. Patients were randomly divided into two groups. Group E underwent an ultrasound-guided ESP block with 20 mL of the local anesthetic mixture at the T-9 level unilaterally on the side of surgery, and group C was a sham group in which 20 mL of normal saline was injected on the side of surgery. Changes in postoperative pain score were the primary outcome, and the duration of analgesia, the total analgesic requirement in 24 hours, and patient satisfaction were the secondary outcomes. ResultsThe demographic data of both groups were comparable. The Visual Analog Scale score was considerably lower in group E than in group C at two, four, six, and eight hours postoperatively. In group E, the mean analgesic duration was substantially longer than that in group C (8.87 ± 2.45 hours vs. 5.67 ± 1.58 hours, respectively). The tramadol requirement was higher in group C (286.67 ± 62.88 mg) than in group E (133.33 ± 47.95 mg) during the 24-hour postoperative period. At 12 hours, patient satisfaction was considerably higher in group E than in group C (6.73 ± 0.45 vs. 5.87 ± 0.35, respectively). ConclusionsThe ultrasound-guided ESP block provided efficient postoperative pain relief, prolonged duration of analgesia, and reduced tramadol intake after PCNL surgery.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Ultrasound-Guided Erector Spinae Plane Block in Percutaneous Nephrolithotomy

Pandey¹,

Yadav²,

Khan³

et al. 2023

Cureus

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“…Ramachandran et al . [ 4 ] compared ESPB to local anaesthetic infiltration of the incision site for postoperative analgesia following PCNL and noted analgesia of 8 h and 30 min, respectively. Kim et al .…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 2 ] General anaesthesia (GA) along with regional anaesthesia techniques such as paravertebral block (PVB), intercostal nerve block, erector spinae plane block (ESPB) and epidural block are used to provide postoperative analgesia for PCNL surgery. [ 3 4 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 5 ] Recent studies have shown that ESPB also effectively provides adequate analgesia postoperatively after PCNL surgery. [ 1 4 6 ] A recent meta-analysis assessing the postoperative analgesic effects of PVB versus ESPB concluded that the postoperative analgesic efficacy of PVB and ESPB varies with the surgical site. [ 7 ] There are no studies directly comparing the efficacy of ESPB with PVB for analgesia following PCNL surgery.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of ultrasound-guided paravertebral block versus erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy – A randomised, double-blind, controlled study

Khot,

Desai,

Bale

et al. 2023

Indian Journal of Anaesthesia

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Background and Aims: Paravertebral block (PVB) is the regional anaesthesia of choice for percutaneous nephrolithotomy (PCNL). Erector spinae plane block (ESPB) is also effective for the same. This study aims to compare the analgesic efficacy and ease of performing PVB or ESPB for PCNL surgery. Methods: This study was conducted in 60 patients undergoing PCNL, who were randomised to Group P (n = 30; received ultrasound-guided [USG] PVB) and Group E (n = 30; received USG ESPB) after general anaesthesia. Blocks were administered at T10 level on the side of the surgery using 20 ml of 0.25% bupivacaine. The trachea was extubated at the end of surgery. The primary outcome was analgesia duration, and secondary outcomes were postoperative pain scores, analgesic consumption, ease of block performance, time taken to perform the block and complications between the two groups. Continuous variables were compared using an independent sample t-test, and categorical variables were analysed using Pearson’s Chi-square test. Results: Demographic variables were comparable in both groups. The mean (standard deviation [SD]) time of first rescue analgesia in Group P and Group E were 16.6 (20.4)(95% confidence interval [CI]: 9.02–20.32) h and 16.3 (21.8) (95% CI: 8.17–24.51) h, respectively (P = 0.95). The postoperative pain scores and number of doses of analgesics used were comparable between the groups (P > 0.05). The time taken to perform PVB was much longer compared to the time taken to perform ESPB (P = 0.01). Conclusion: USG PVB and ESPB were equally effective for postoperative analgesia for PCNL surgery.

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“…Apart from the usual and new blocks for limb surgeries being performed under vision,[ 4 5 6 7 8 9 ] with the diminishing size of the machine and better resolution, a whole armamentarium of fascial plane blocks and surrogate central neuraxial blocks such as paravertebral[ 10 11 12 ] and erector spinae plane blocks[ 13 14 15 16 17 ] are now available to the anaesthesiologists. Spinal,[ 18 19 ] epidural[ 20 21 22 ] and even caudal blocks[ 23 ] can now be performed under vision, especially in paediatrics.…”

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confidence: 99%

Advancing, strengthening and reshaping obstetric critical care with Point-of-Care Ultrasound (POCUS)

Mehdiratta¹,

Kumar²,

Bajwa³

2021

Indian Journal of Anaesthesia

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Comparison of erector spinae plane block and local anaesthetic infiltration of the incision site for postoperative analgesia in percutaneous nephrolithotomy – A randomised parallel-group study

Cited by 13 publications

References 31 publications

Efficacy of Ultrasound-Guided Erector Spinae Plane Block in Percutaneous Nephrolithotomy

Efficacy of Ultrasound-Guided Erector Spinae Plane Block in Percutaneous Nephrolithotomy

Comparison of ultrasound-guided paravertebral block versus erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy – A randomised, double-blind, controlled study

Advancing, strengthening and reshaping obstetric critical care with Point-of-Care Ultrasound (POCUS)

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