Erector Spinae Plane Block, Nephrolithotomy, Percutaneous, Postoperative Pain
Conditions
Brief summary
This study investigates the effectiveness of the erector spinae plane block (ESPB) in pain management of patients undergoing PNL.
Detailed description
Although percutaneous nephrolithotomy(PNL) is a minimally invasive procedure, it causes severe postoperative pain due to dilatation of the renal capsule and parenchymal duct and peritubal distension of the nephrostomy tube. PNL-related pain has a limited response to oral and intravenous treatments. The primary aim of our study is to investigate the effectiveness of the erector spinae plane block (ESPB) in pain management of patients undergoing PNL. Our secondary aim is determining if any possible clinical effect of ESPB in terms of serial peak expiratory flow measurements, postoperative agitation score of the patient (Riker Score), ambulation time, length of hospital stay.
Interventions
PROCEDUREerector spinae block
we administer 15 cc of 0.5% bupivacaine between the erector spine muscle and the transverse process. The distribution of bupivacain was observed on ultrasound.
Sponsors
Ankara City Hospital Bilkent
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* patients undergoing PNL between 18-65 years old
Exclusion criteria
* serious cardiac, respiratory, hepatic, renal or haemotologic disease * mental disorder and hearing problem * anxiety, depression and / or other psychiatric disorders * pregnancy * refusal of patient * Allergy or contraindications to drugs used in the study * ASA \> 2 Inflammation or infection over injection site Obese patients BMI ≥35/
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale | postoperative 24 hours | the amount of pain that a patient feels ranges across a continuum from none(0) to an extreme amount of pain(10) on a chart. |
| Dynamic Visual Analog Scale | postoperative 24 hours | the amount of pain during mobilization, deep breathing or coughing that a patient feels ranges across a continuum from none(0) to an extreme amount of pain(10) on a chart |
| Peak Expiratory Flow Rate( PEFR) | postoperative 24 hours | maximum speed of expiration as measured with a peak flow meter |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rikert Agitation Scale | 24 hours | postoperative agitation score 1. unarousable 2. very sedated 3. sedated 4. calm and cooperative 5. agitated 6. very agitated 7. dangerous agitation |
| nausea and vomiting | 24 hours | incidence of nausea and vomiting |
| patient satisfaction with anesthesia and analgesia | 24 hour | 4 Likert scale ( the level of satisfaction of a patient ranges from satisfied (1) to nonsatisfied(4) |
| Time for first analgesic requirement | 24 hours | Time between end of surgery and patients first analgesic demand |
| urinary catheter releated pain score(Visual Analog Scale) | postoperative 24 hours | the amount of pain that a patient feels ranges across a continuum from none(0) to an extreme amount of pain(10) on a chart. |
| surgeon satisfaction with anesthesia and analgesia | 24 hour | 4 Likert scale ( the level of satisfaction of surgeon ranges from satisfied (1) to nonsatisfied(4) |
| starting oral intake | 48 hours | first oral intake |
| ambulation time | 5 days | first postoperative mobilization time of the patient |
| length of hospital stay | 1 week | day of hospitalization |
Countries
Turkey (Türkiye)
Outcome results
None listed