Percutaneous Nephrolithotomy under Thoracic Paravertebral Block: A Preliminary Report

Ahmed, Doaa G; Hetta, Diab Fuad; Abdelraouf, Abdelraouf M S

doi:10.4172/2155-6148.1000720

Cited by 5 publications

(6 citation statements)

References 27 publications

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“…conducted a study on second look PCNL where conscious sedation using dexmedetomidine and paravertebral block was used for anesthesia and postoperative analgesia. [ 26 ] The average time for first rescue analgesia in the postoperative period was 15 ± 3.9 hours compared to 17.22 ± 0.97 hours in ESPB patients in our study. Lönnqvist et al .…”

Section: Discussionmentioning

confidence: 55%

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Postoperative analgesic efficacy of fluoroscopy-guided erector spinae plane block after percutaneous nephrolithotomy (PCNL): A randomized controlled study

Prasad¹,

Varshney²,

Jain³

et al. 2020

Saudi J Anaesth

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Section: Discussionmentioning

confidence: 55%

“…in their case series found that patients with PVB to be satisfied in postoperative period. [ 26 ] However, since no data comparing ESPB with PVB are available, we cannot edge ESPB over PVB but is definitely providing better postoperative pain relief than conventional opioid-based or opioid-free analgesia.…”

Section: Discussionmentioning

confidence: 99%

Postoperative analgesic efficacy of fluoroscopy-guided erector spinae plane block after percutaneous nephrolithotomy (PCNL): A randomized controlled study

Prasad¹,

Varshney²,

Jain³

et al. 2020

Saudi J Anaesth

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“…Secondary objectives were postoperative pain scores and analgesic consumption, which were recorded up to 48 h postoperatively, ease of block performance and time taken to perform the block, which was noted during the block performance. An earlier study on PVB indicated that the mean (standard deviation [SD]) duration of analgesia following PVB for PCNL was 15 (3.9) h.[ 9 ] For a 20% change in duration of analgesia with 80% power and an α-error of 0.05, we calculated that 27 patients were needed in each group. Considering possible dropouts, we planned to include 30 patients in each group.…”

Section: Methodsmentioning

confidence: 99%

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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“…Using PASS program, setting alpha error at 5% and power 80%. Result from previous study [13] Based on this the needed sample we recruited 100 cases for the study.…”

Section: Sample Sizementioning

confidence: 99%

An Easy Way for Percutaneous Nephrolithotomy Using Mixed Sedative Agents

Abdou¹,

Kamel²,

Abo-Seif³

2018

OJAnes

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Objective: We recorded the data of patients performing Percutaneous Nephrolithotomy (PCNL) under combined spinal anesthesia with sedative mixtures of Ketamine-Propofol (KP) or Fentanyl-Propofol (FP). Background: The PCNL is usually done under General anesthesia (GA); combining spinal anesthesia with a mixture of sedative drugs has shown to provide an optimum intra and post-operative analgesic and sedative response without side effects. Patients and Methods: 100 healthy patients were enrolled for PCNL, after stabilization of the sensory block of spinal anesthesia patients were randomized into two groups; Group KP received 1 mg/Kg Ketamine and 1 mg/Kg Propofol diluted in 20 ml syringe given over 30 seconds and Group FP received 1 mic/Kg Fentanyl and 1 mg/Kg Propofol diluted in 20 ml syringe over 30 seconds; both groups will receive increment doses if the patient suffers from anxiety, pain or discomfort. Perioperative Hemodynamic data (HR, SBP, DBP, RR, and SpO2) were recorded; PACU stay time and post operative analgesia time were analyzed. Results: Sedative mixtures of FP and KP provided remarkably deep sedation levels for PCNL procedures under spinal anesthesia. Respiratory depression, hypotension and bradycardia were the major side effects reported in FP group which had mean decrease in RR of 4.63 breath/min (27.49%) with mean 3.77% drop in SpO2 levels. KP group produced significant increase in HR about 7 beats/min without reported side effects. Conclusion: Various sedation techniques may be applicable for PCNL procedures with routine premedication, mixtures of fentanyl-Propofol or Ketamine-Propofol could be used, and KP has advantages of stable hemodynamics, prolonged analgesic response intra and post-operatively with no appreciable side effects and more effective method of sedative mixture.

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Percutaneous Nephrolithotomy under Thoracic Paravertebral Block: A Preliminary Report

Abstract: Background: The second look percutaneous nephrolithotomy (PCNL) is usually done under general anesthesia. Thoracic paravertebral block has been shown to provide sufficient postoperative analgesia for a variety of thoracic and upper abdominal surgeries.

Cited by 5 publications

References 27 publications

Postoperative analgesic efficacy of fluoroscopy-guided erector spinae plane block after percutaneous nephrolithotomy (PCNL): A randomized controlled study

Postoperative analgesic efficacy of fluoroscopy-guided erector spinae plane block after percutaneous nephrolithotomy (PCNL): A randomized controlled study

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

An Easy Way for Percutaneous Nephrolithotomy Using Mixed Sedative Agents

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