Evaluation of the Efficacy of the Erector Spinae Plane Block for Postoperative Pain in Patients Undergoing Percutaneous Nephrolithotomy: A Randomized Controlled Trial

Abstract

Purpose: To compare the efficacy of the erector spinae plane block (ESPB) and conventional analgesia (CA) in pain management after percutaneous nephrolithotomy (PCNL). Materials and Methods: After obtaining the approval of the institutional ethics committee and patients' written informed consent, 60 cases ages 18 to 65 years, with the status of American Society of Anesthesia I/II and body mass index of 18.5 to 30, were included in the study. The patients were randomized to receive ESPB or CA by a computer-based list. Results: The demographic parameters were similar in both groups. Regarding the visual analog scale (VAS) score assessment, the patients in the ESPB group described statistically less pain according to the total score and evaluations at hours 0, 1, 6, and 24 (p = 0.001, 0.009, <0.001, and 0.014, respectively). The time to first rescue analgesic was longer in the ESPB group compared with the CA group (172.33 ± 180.5 minutes vs 84.33 ± 71.12 minutes), which was statistically significant (p = 0.016). The use of tramadol and paracetamol was less in the ESPB group (60 ± 72.3 mg vs 120 ± 55 mg and 1.8 ± 0.76 g vs 3.2 ± 0.99 g, respectively). (p = 0.001 and <0.001, respectively). Conclusions: ESPB is a safe technique that provides effective postoperative analgesia in patients undergoing PCNL. ESPB decreases the postoperative VAS score, prolongs the salvage analgesia time, and reduces the need for paracetamol and tramadol use compared with general anesthesia with CA.

Keywords: erector spinae plane block; pain; percutaneous nephrolithotomy.