Department of Anesthesiology and Reanimation, Faculty of Medicine, University of Eskişehir Osmangazi, 26040, Eskişehir, Turkey.
Department of Urology, Faculty of Medicine, University of Kırıkkale, Kırıkkale, Turkey.
BMC Anesthesiol. 2020 Sep 29;20(1):250. doi: 10.1186/s12871-020-01169-6.
Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, efficacious in operations performed. This study was undertaken to evaluate how efficacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN).
A total of 44 patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects profile and the need for supplemental analgesia.
Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical significance in the PVB group compared to controls at 2 and 4 h post-surgery. At 6 and 8 h post-surgery, the control group had a lower VAS score when moving, and this result reached statistical significance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05).
Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications.
ClinicalTrials.gov , NCT04406012. Registered retrospectively, on 27 May 2020.
椎旁阻滞（PVB）用于有效管理各种胸腔、腹部或骨盆手术引起的疼痛。PVB 操作简单，在手术中效果显著。本研究旨在评估超声引导下胸椎旁神经阻滞在经皮肾镜取石术（PCN）患者中的效果。
共纳入 44 名 ASA 分级 I 至 III 级、年龄在 18 至 65 岁之间、拟行 PCN 的患者，随机分为两组。麻醉干预组（PVB 组）22 例，在 T8-T9 水平单次注射 20ml0.25%布比卡因。对照组 C 组 22 例，不进行干预。比较两组 PCN 后阿片类药物使用、疼痛评分、阿片类药物不良反应谱和补充镇痛需求。
PVB 组术后 2、4 小时静息和活动时的视觉模拟评分（VAS）疼痛评分低于对照组，差异具有统计学意义。术后 6、8 小时，对照组活动时 VAS 评分较低，差异有统计学意义（p<0.05）。对照组使用的阿片类药物缓解疼痛多于 PVB 组，满意度评分较低（p<0.05）。
使用布比卡因和平面内技术的超声引导 PVB 在 PNL 中提供有效的镇痛。它与患者满意度高和并发症少有关。
ClinicalTrials.gov，NCT04406012。于 2020 年 5 月 27 日回顾性注册。
