Comparison of Erector Spinae Plane Block and Intravenous Patient-controlled Analgesia in Percutaneous Nephrolithotomy
Condition: Nephrolithiasis; Percutaneous; Analgesia; PCA
MeSH terms: Nephrolithiasis; Kidney Calculi
Study type: Interventional

Summary: 
      The primary purpose of this study was to compare the effects of erector spinal plane block
      (ESP) and IV patient-controlled analgesia (PCA) performed to provide analgesia in
      percutaneous nephrolithotomy surgeries on visual analog skala (VAS), additional analgesia
      need, patient satisfaction and mobilization times.
    

Detailed description: 
      ASA I-III patients aged 18-65 years who underwent percutaneous nephrolithotomy at Van Yüzüncü
      Yıl University Faculty of Medicine were included in the study.

      The patients were informed about the study during the preoperative evaluation. In the
      randomized single-blind closed-envelope study, 30 patients ineach group and a total of 60
      patients were included. Standard general anesthesia procedure was applied to all patients.
      Standard general anesthesia procedure was applied to all patients. Perioperative hemodynamic
      monitoring was performed. In patients who underwent general anesthesia, after the surgical
      procedure was completed, after sterility was ensured for the ESP group while the patient was
      in the lateral position for the ESPB procedure, the linear 10-18 MHz USG probe (Esaote MyLab
      30, Geneva, Italy) was placed between two transverse processes in the paramedian plane and
      increased from 1mg/kg to %1 at the T7 level. 20 ml of 0.5 bupivacaine (Buvasin®, Vem,
      Istanbul, Turkey) + 2% arrhythmic residual SF from 1mg/kg was administered. For patients in
      the PCA group, 200 mg of tramadol was placed in 100cc of 0.9% NaCl. Set to PCA device. A 50mg
      loading dose was administered 10 minutes before the patient was extubated. After extubating,
      a bolus dose of 20 mg was started, with a 30-minute lock-in time, and an infusion dose of
      5mg/hour. The 4-hour maximum limit was set to 200 mg.

      VAS score, need for additional analgesia, patient satisfaction (Likert scale), mobilization
      times and vital signs were recorded at 30 minutes, p1, 3, 6 and 12 hours after the operation.
    

Intervention name(s): Bupivakain + deksametazon Adjuvant
Intervention type(s): Procedure
Intervention description(s): In patients who underwent general anesthesia, after the surgical procedure was completed, after sterility was ensured for the ESP group while the patient was in the lateral position for the ESPB procedure, the linear 10-18 MHz USG probe (Esaote MyLab 30, Geneva, Italy) was placed between two transverse processes in the paramedian plane and increased from 1mg/kg to %1 at the T7 level. 20 ml of 0.5 bupivacaine (Buvasin®, Vem, Istanbul, Turkey) + 2% arrhythmic residual SF from 1mg/kg was administered. For patients in the PCA group, 200 mg of tramadol was placed in 100cc of 0.9% NaCl. Set to PCA device. A 50mg loading dose was administered 10 minutes before the patient was extubated. After extubating, a bolus dose of 20 mg was started, with a 30-minute lock-in time, and an infusion dose of 5mg/hour. The 4-hour maximum limit was set to 200 mg.
Other intervention name(s): PCA, Patient Controlled Analgesia
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The patients weredivided in two groups. Thirty patients were assigned to each group. Standard general anesthesia procedure was applied to all patients. Perioperative hemodynamic monitoring was performed. Group ESP underwent an erector spina block after the surgical procedure. Intravenous patient-controlled analgesia with tramadol was applied to group PCA patients. VAS score, need for additional analgesia, patient satisfaction (Likert scale), mobilization times and vital signs were recorded at 30 minutes, 1th, 3th, 6th and 12th hours after the operation.
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Percutaneous; Nephrolithotomy; Plane Block; Patient-controlled analgesia