The Comparison of Low Thoracic Paravertebral Block Versus Peritubal Infiltration
Status:
Completed
Trial end date:
2016-08-01
Target enrollment:
Participant gender:
Summary
Percutaneous nephrolithotomy (PCNL) is a safe and effective procedure that is considered the
standard treatment for large and complex renal stones. Although it has lower complication and
morbidity rates than open surgery, the pain and discomfort related to a nephrostomy tube can
cause distress for patients.
Managing this pain with opioids can lead to sedation, nausea, vomiting, and constipation,
which defeat the purpose of this minimally invasive procedure.
Skin infiltration with bupivacaine around the nephrostomy tube is not effective. Infiltration
of renal capsule has shown to facilitate painless insertion of nephrostomy tube, suggesting
the role of renal capsule in pain management.
Peritubal infiltration of bupivacaine from renal capsule to the skin along the nephrostomy
tract may alleviate postoperative pain. A unilateral Low thoracic paravertebral (PVB) block
offers the option of providing extendable perioperative pain relief without the above side
effects or the physiologic derangement associated with local anesthetics in the central
neuraxial space.
The aim of this study is to determine whether ultrasound guided low thoracic paravertebral
block effective post-operative analgesia as compared to peritubal infiltration analgesia in
patients undergoing percutaneous nephrolithotomy.
Main outcome measures: The primary endpoint is postoperative opioid consumption. Secondary
endpoints are visual analogue pain scores, opioid related side effects.