Kidney Calculi
Conditions
Keywords
paravertebral block, ultrasound, percutaneous nephrolithotomy, postoperative pain
Brief summary
This prospective, randomized study is aimed to assess the efficacy and safety of paravertebral block compared to epidural anesthesia for percutaneous nephrolithotomy. The investigators suppose that paravertebral block is not inferior in controlling the perioperative pain for percutaneous nephrolithotomy compared to epidural block.
Detailed description
Background: Percutaneous nephrolithotomy (PCNL) is generally performed under general or neuraxial anesthesia. The investigators have reported three patients who were at high risk of both general anesthesia and neuraxial anesthesia received percutaneous nephrolithotomy with ultrasound guided paravertebral block. Then，The investigators performed ultrasound guided paravertebral block for 45 patients who received percutaneous nephrolithotomy successfully. The investigators' impression is that paravertebral block is as effective as epidural anesthesia for surgical anesthesia of percutaneous nephrolithotomy. Objectives:To assess the efficacy and safety of paravertebral block compared to epidural anesthesia for surgical anesthesia of percutaneous nephrolithotomy. Methods: Fifty adult patients undergoing elective percutaneous nephrolithotomy will be randomized to receive ultrasound guided paravertebral block or epidural anesthesia. The primary outcome will be the pain score 12h postoperation. The secondary outcomes will include: time spent to perform block, dose of intraoperative opioids, rate of hypotension need for vasoconstrictors, muscle Power Grading of the lower legs at the end of the operation, anus exhaust time, opioid consumption postoperation, postoperative PONV score and the frequency of vomiting , hospitalization duration and patient satisfaction. Clinical Implications: Ultrasound guided paravertebral block could be an equally effective and safe alternative to epidural block for surgical anesthesia of percutaneous nephrolithotomy.
Interventions
PROCEDUREparavertebral block
Ultrasound guided two-segment paravertebral block
PROCEDUREepidural anesthesia
thoracic epidural anesthesia
Sponsors
Huazhong University of Science and Technology
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* American Society of Anesthesiologists physical statusⅠ-Ⅲ * Undergo first stage percutaneous nephrolithotomy * Informed consent
Exclusion criteria
* BMI\>35 * Coagulopathy, on anticoagulants * History of surgery on spine * Spine deformity * A known allergy to the drugs being used * Tumor or infection at the site of puncture * inability to provide adequate informed consent * refusal to participate in the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| pain score 12h post operation | 12 hours postoperation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| dose of intraoperative opioids | during operation | — |
| rate of hypotension | during operation | — |
| Muscle Power Grading of the lower legs at the end of the operation | 12 hours postoperation | — |
| time spent to perform block | during block | — |
| postoperative PONV score and the frequency of vomiting | 24 hours postoperation | — |
| Hospitalization duration | 10 days postoperation | — |
| Patient satisfaction | one day before discharge | Patient satisfaction will be evaluated by 5-point Likert scal |
| opioid consumption postoperation | 12 hours postoperation | — |
Countries
China
Outcome results
None listed