Efficacy of ultrasound guided Thoracic Paravertebral block for postoperative analgesia in Patients Undergoing Percutaneous Nephrolithotomy Surgeries


  • Vijetha Devaram Narayana Medical College, Nellore-524003. India
  • Shiny Priyadarshini Arumulla Department of Anaesthesiology, Narayana Medical College, Nellore, A.P.
  • Jayanth Midathala Narayana Medical College, Nellore-524003. India
  • Bhargava Reddy K. V. Narayana Medical College, Nellore-524003. India
  • Sukanya Mallela Narayana Medical College, Nellore-524003. India
  • Krishna Chaitanya K. Narayana Medical College, Nellore-524003. India
  • Hari Prasad Reddy Basireddy Narayana Medical College, Nellore-524003. India




percutaneous nephrolithotomy, ultrasound-guided paravertebral block, postoperative analgesia, visual analogue scale


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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Efficacy of ultrasound guided Thoracic Paravertebral block for postoperative analgesia in Patients Undergoing Percutaneous Nephrolithotomy Surgeries




How to Cite

Devaram V, Arumulla SP, Midathala J, Reddy B, Mallela S, Chaitanya K, Prasad H. Efficacy of ultrasound guided Thoracic Paravertebral block for postoperative analgesia in Patients Undergoing Percutaneous Nephrolithotomy Surgeries. PMJUA [Internet]. 2023 Mar. 23 [cited 2023 May 29];7(4). Available from: https://painmedicine.org.ua/index.php/pnmdcn/article/view/338



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