Rashmee Vijay Chavan1, Archita Rajaram Patil2, Anupama Deepak Sahasrabudhe3, Aarati Bhaskar Jadhav4, Prithiv Rishardhan Prabhakaran5
BACKGROUND
Post-operative pain and discomfort is a common side effect of percutaneous
nephrolithotomy (PCNL) surgery. The study intended to evaluate the efficacy of
landmark guided erector spinae plane block (ESPB) in early post-operative pain
relief following (PCNL) surgery.
METHODS
In this randomised prospective, single blind, interventional study, 70 patients aged
20 - 60 years of ASA grade I and II, scheduled for elective percutaneous
nephrolithotomy (PCNL) surgery under general anaesthesia were included.
Patients were randomly allotted into two groups of 35 each. Group 1 was the
control group and received parenteral analgesia according to institutional protocol
for postoperative pain relief. Group 2 was the study group and received landmark
guided erector spinae plane block (ESPB) with 20 cc of 0.25 % bupivacaine for
postoperative pain relief. Post-operatively patients were monitored for pain and
Visual Analogue Scale (VAS) score was noted at 2nd, 4th and 6th hr and was
maintained below 4 by providing them with additional analgesics if required. Time
and doses of analgesics required were recorded.
RESULTS
All the statistical analysis was done using R-Studio 1.2.5001 software. Mann-
Whitney-U test was used for quantitative variables of pain score. Proportion test
was used for qualitative demographic data and for post-operative analgesics
requirement. Both the groups were comparable on demographic variables. The
average VAS score at 2nd and 4th hr was significantly lower in the study group than
in the control group (P < 0.05). The VAS score at 6th hr was comparable in both
the groups. The analgesic requirement was significantly lower in study group as
compared to the control group.
CONCLUSIONS
The landmark guided ESPB is an effective and simple method to alleviate
immediate postoperative pain in PCNL surgeries under general anaesthesia.
