Hatipoglu Zehra, Gulec Ersel, Turktan Mediha, Izol Volkan, Arıdogan Atilla, Gunes Yasemin, Ozcengiz Dilek
Faculty of Medicine, Department of Anaesthesiology and Reanimation, Cukurova University, 01250, Adana, Turkey.
Faculty of Medicine, Department of Urology, Cukurova University, Adana, Turkey.
BMC Anesthesiol. 2018 Feb 17;18(1):24. doi: 10.1186/s12871-018-0479-7.
Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure for renal calculi, and nephrostomy tubes lead to postoperative pain after PCNL. Regional techniques (e.g., epidural analgesia and peripheral blocks) and opioids are applied for postoperative pain treatment. The aim of this study was to compare effectiveness of ultrasound-guided paravertebral block (PVB) and tramadol on postoperative pain in patients who underwent PCNL.
Fifty-three patients were included in this prospective randomized study. The patients were allocated into two groups: the PVB group (group P, n = 26) and the tramadol group (group T, n = 27). All patients were administered standard general anaesthesia. Ultrasound-guided PVB was performed at the T11- L1 levels using 0.5% bupivacaine for a total dose of 15 mL in group P. Patients in group T were intravenously administered a loading dose of 1 mg/kg tramadol. Patients in both groups were given patient-controlled analgesia. Haemodynamic parameters, visual analogue scale (VAS) scores, side effects, and complications, tramadol consumption and additional analgesic requirements of the patients were recorded after surgery.
Haemodynamic parameters were statistically similar between the groups. The VAS in group P were statistically lower than in group T. In the 24-h period after surgery, total PCA tramadol consumption was statistically lower in group P than in group T. The use of supplemental analgesic in group T was higher than in group P.
Ultrasound-guided PVB was found to be an effective analgesia compared to tramadol, and no additional complications were encountered.
ClinicalTrials.gov, NCT02412930 , date of registration: March 27, 2015, retrospectively registered.
经皮肾镜取石术（PCNL）是一种治疗肾结石的微创手术，肾造瘘管会导致PCNL术后疼痛。区域技术（如硬膜外镇痛和外周阻滞）和阿片类药物用于术后疼痛治疗。本研究的目的是比较超声引导下椎旁阻滞（PVB）和曲马多对接受PCNL患者术后疼痛的疗效。
本前瞻性随机研究纳入了53例患者。患者被分为两组：PVB组（P组，n = 26）和曲马多组（T组，n = 27）。所有患者均接受标准全身麻醉。P组在T11-L1水平使用0.5%布比卡因进行超声引导下PVB，总剂量为15 mL。T组患者静脉注射1 mg/kg曲马多负荷剂量。两组患者均给予患者自控镇痛。记录术后患者的血流动力学参数、视觉模拟评分（VAS）、副作用、并发症、曲马多消耗量和额外镇痛需求。
两组间血流动力学参数在统计学上相似。P组的VAS在统计学上低于T组。术后24小时内，P组PCA曲马多总消耗量在统计学上低于T组。T组补充镇痛药的使用高于P组。
与曲马多相比，超声引导下PVB是一种有效的镇痛方法，且未出现额外并发症。
ClinicalTrials.gov，NCT02412930，注册日期：2015年3月27日，回顾性注册。
