A Prospective, Randomised, Double-blind Comparative Study for Efficacy of Paravertebral Block by Ropivacaine in Postoperative Analgesia after Percutaneous Nephrolithotomy

Abstract

Introduction: Percutaneous Nephrolithotomy (PCNL) is a painful procedure that involves placement of large bore access sheath in the flank through which stones are fragmented and then removed. Inability to control this pain may hamper discharge from hospital and might lengthen their return to work. Aim: To evaluate the efficacy of Paravertebral Block (PVB) with ropivacaine on postoperative pain management in patients after PCNL. Materials and Methods: A prospective randomized doubleblind comparative study was conducted from January 2012 to December 2013 in 60 adult patients posted for PCNL. Sixty patients were randomized into two groups of 30 each: Group A received PVB with ropivacaine while Group B was the control group who did not receive PVB. In the postoperative period, the pain status of patients was evaluated at postoperative 6 and 24 hours by using the Visual Analogue Scale (VAS). Continuous data were described as mean±standard deviation and categorical variables are given as number (%). Continuous variables were compared using t-test for two independent samples. Percentages were compared using Chi-square analysis. Results: There was no statistically significant difference between the two groups regarding the demographic characteristics, surgical complications, and postoperative hospital stay. Our findings revealed that in Group A, VAS score was lower significantly at 6 hours (p<0.001) but not at 24 hours (p=0.082). Requirement of rescue analgesia was lower (p<0.05), when compared with the Group B. Conclusion: PVB by Ropivacaine was shown to be safe and efficacious as an analgesia method after PCNL.

Keywords

• pain
• rescue analgesia
• visual analogue scale