Efficacy of ultrasound guided Thoracic Paravertebral block for postoperative analgesia in Patients Undergoing Percutaneous Nephrolithotomy Surgeries
Background: percutaneous nephrolithotomy (PCNL) is a minimally invasive surgery to treat renal stones. Post-operative pain is distressing to the patient due to the injury to the capsule. Efficacy of ultrasound-guided thoracic paravertebral block at multiple level (T9–T10, T10–T11, T11–T12) was eval...
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| Format: | Article |
| Language: | English |
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Interdisciplinary Academy of Pain Medicine
2023-03-01
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| Series: | Медицина болю |
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| Online Access: | https://painmedicine.org.ua/index.php/pnmdcn/article/view/338 |
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| author | Vijetha Devaram Shiny Priyadarshini Arumulla Jayanth Midathala Bhargava Reddy Sukanya Mallela Krishna Chaitanya Hari Prasad |
| author_facet | Vijetha Devaram Shiny Priyadarshini Arumulla Jayanth Midathala Bhargava Reddy Sukanya Mallela Krishna Chaitanya Hari Prasad |
| author_sort | Vijetha Devaram |
| collection | DOAJ |
| description |
Background: percutaneous nephrolithotomy (PCNL) is a minimally invasive surgery to treat renal stones. Post-operative pain is distressing to the patient due to the injury to the capsule. Efficacy of ultrasound-guided thoracic paravertebral block at multiple level (T9–T10, T10–T11, T11–T12) was evaluated to manage postoperative analgesia in percutaneous nephrolithotomy surgeries.
Methodology: a prospective randomized double-blind study of 60 cases of the American Society of Anesthesiologists I–II patients who underwent percutaneous nephrolithotomy were allocated into group P (test) and group N (control). Immediately after surgery, group P were given ultrasound-guided paravertebral block at T9–T10, T10–T11, T11–T12 on operated side using 5 ml of 0.25 % Levobupivacine at each level, while group N did not receive paravertebral block. The patients were assessed for visual analogue scale (VAS), time for first rescue analgesic, number of rescue analgesics in first 24 hrs postoperatively.
Results: VAS pain scale shows significant difference between group P (4.2 + 0.8) and group N (5.3 + 1.1) (p < 0.05) at 30 mins, 2, 4, 8 hrs postoperatively. Total opioid consumption at postoperative 2, 6, and 24 hrs was less in group P than group N (P < 0.05). Number of rescue analgesics in first 24 hrs post-surgery in group P was 3.0 ± 0.4, and 4.0 ± 1.1 in group N with statistical significant difference (p = 0.0001). Total dose of opioid consumption (mg) in group P was 110 ± 40.45, and 155 ± 64.87 mg in group N with statistical significant difference (p = 0.002). The group N cases used more opioid than group P, with lower scores for satisfaction (p < 0.05). Analgesic consumption in postoperative 24 hrs of group P was less than that of group N (P = 0.001). Patient satisfaction score was significantly higher in group P than group N (P = 0.0001) in 24 hrs. No nausea and/or vomiting were noted in both groups.
Conclusion: ultrasound-guided thoracic paravertebral block had more analgesic, and reduce the requirement of opioids and maintains stable hemodynamics.
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| first_indexed | 2024-04-09T22:18:23Z |
| format | Article |
| id | doaj.art-76e1c3e38314479bb0a35f4bb60054fe |
| institution | Directory Open Access Journal |
| issn | 2414-3812 2519-2752 |
| language | English |
| last_indexed | 2024-04-09T22:18:23Z |
| publishDate | 2023-03-01 |
| publisher | Interdisciplinary Academy of Pain Medicine |
| record_format | Article |
| series | Медицина болю |
| spelling | doaj.art-76e1c3e38314479bb0a35f4bb60054fe2023-03-22T22:16:30ZengInterdisciplinary Academy of Pain MedicineМедицина болю2414-38122519-27522023-03-017410.31636/pmjua.v7i4.1Efficacy of ultrasound guided Thoracic Paravertebral block for postoperative analgesia in Patients Undergoing Percutaneous Nephrolithotomy SurgeriesVijetha Devaram0Shiny Priyadarshini Arumulla1Jayanth Midathala2Bhargava Reddy3Sukanya Mallela4Krishna Chaitanya5Hari Prasad6Narayana Medical College, Nellore-524003. IndiaDepartment of Anaesthesiology, Narayana Medical College, Nellore, A.P.Narayana Medical College, Nellore-524003. IndiaNarayana Medical College, Nellore-524003. IndiaNarayana Medical College, Nellore-524003. IndiaNarayana Medical College, Nellore-524003. IndiaNarayana Medical College, Nellore-524003. India Background: percutaneous nephrolithotomy (PCNL) is a minimally invasive surgery to treat renal stones. Post-operative pain is distressing to the patient due to the injury to the capsule. Efficacy of ultrasound-guided thoracic paravertebral block at multiple level (T9–T10, T10–T11, T11–T12) was evaluated to manage postoperative analgesia in percutaneous nephrolithotomy surgeries. Methodology: a prospective randomized double-blind study of 60 cases of the American Society of Anesthesiologists I–II patients who underwent percutaneous nephrolithotomy were allocated into group P (test) and group N (control). Immediately after surgery, group P were given ultrasound-guided paravertebral block at T9–T10, T10–T11, T11–T12 on operated side using 5 ml of 0.25 % Levobupivacine at each level, while group N did not receive paravertebral block. The patients were assessed for visual analogue scale (VAS), time for first rescue analgesic, number of rescue analgesics in first 24 hrs postoperatively. Results: VAS pain scale shows significant difference between group P (4.2 + 0.8) and group N (5.3 + 1.1) (p < 0.05) at 30 mins, 2, 4, 8 hrs postoperatively. Total opioid consumption at postoperative 2, 6, and 24 hrs was less in group P than group N (P < 0.05). Number of rescue analgesics in first 24 hrs post-surgery in group P was 3.0 ± 0.4, and 4.0 ± 1.1 in group N with statistical significant difference (p = 0.0001). Total dose of opioid consumption (mg) in group P was 110 ± 40.45, and 155 ± 64.87 mg in group N with statistical significant difference (p = 0.002). The group N cases used more opioid than group P, with lower scores for satisfaction (p < 0.05). Analgesic consumption in postoperative 24 hrs of group P was less than that of group N (P = 0.001). Patient satisfaction score was significantly higher in group P than group N (P = 0.0001) in 24 hrs. No nausea and/or vomiting were noted in both groups. Conclusion: ultrasound-guided thoracic paravertebral block had more analgesic, and reduce the requirement of opioids and maintains stable hemodynamics. https://painmedicine.org.ua/index.php/pnmdcn/article/view/338percutaneous nephrolithotomyultrasound-guided paravertebral blockpostoperative analgesiavisual analogue scale |
| spellingShingle | Vijetha Devaram Shiny Priyadarshini Arumulla Jayanth Midathala Bhargava Reddy Sukanya Mallela Krishna Chaitanya Hari Prasad Efficacy of ultrasound guided Thoracic Paravertebral block for postoperative analgesia in Patients Undergoing Percutaneous Nephrolithotomy Surgeries Медицина болю percutaneous nephrolithotomy ultrasound-guided paravertebral block postoperative analgesia visual analogue scale |
| title | Efficacy of ultrasound guided Thoracic Paravertebral block for postoperative analgesia in Patients Undergoing Percutaneous Nephrolithotomy Surgeries |
| title_full | Efficacy of ultrasound guided Thoracic Paravertebral block for postoperative analgesia in Patients Undergoing Percutaneous Nephrolithotomy Surgeries |
| title_fullStr | Efficacy of ultrasound guided Thoracic Paravertebral block for postoperative analgesia in Patients Undergoing Percutaneous Nephrolithotomy Surgeries |
| title_full_unstemmed | Efficacy of ultrasound guided Thoracic Paravertebral block for postoperative analgesia in Patients Undergoing Percutaneous Nephrolithotomy Surgeries |
| title_short | Efficacy of ultrasound guided Thoracic Paravertebral block for postoperative analgesia in Patients Undergoing Percutaneous Nephrolithotomy Surgeries |
| title_sort | efficacy of ultrasound guided thoracic paravertebral block for postoperative analgesia in patients undergoing percutaneous nephrolithotomy surgeries |
| topic | percutaneous nephrolithotomy ultrasound-guided paravertebral block postoperative analgesia visual analogue scale |
| url | https://painmedicine.org.ua/index.php/pnmdcn/article/view/338 |
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