Department of Anaesthesiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen(518053), China
Abstract:
Objective To investigate the effect of ultrasound-guided single-point single-dose thoracic paravertebral block (ThPVB) on analgesia effect and morphine consumption in patients undergoing percutaneous nephrolithotomy (PCNL). Methods 50 patients scheduled for elective percutaneous nephrolithotomy were randomized into ThPVB group ( Group P) and Control group ( Group C). After the procedure, in the group P, a single-shot ThPVB with 0.5% ropivacaine (Naropin) 10ml was performed at the T11 thoracic paravertebral space under the guidance of Sonosite M-Turbo. ThPVB was not performed in group C. patients in both groups received patient-controlled analgesia service with morphine. Heart rate (HR), peripheral pulse oxygen saturation (SPO2), respiratory rate (RR) and noninvasive blood pressure (BP) before the anesthesia, during and after the procedure were recorded . The NRS score, RR, and Ramsey sedation score 24 h after tracheal extubation were recorded, as well as the total consumption of morphine (MC) , adverse reactions , patient satisfaction (Level of Satisfaction, LOS). Results The movement NRS score of patients in group P was 1.4±1.4, 1.9±1.3, 2.2±1.4, 2.3±1.0, 2.4±1.6, 1.9±0.9 and1.6±0.9， at 0.5h, 1 h, 2h, 4 h, 8 h, 12 h and 24 h after extubation respectively. The rest NRS score at the same time point was 0.3±0.7, 0.7±0.9, 0.9±1.0, 1.1± 0.9,1.0±1.0, 0.6±0.7 and0.4±0.6 respectively. Both movement and rest NRS scores in group P were lower than that of the group C (P<0.05 Or P<0.01). The Ramsay sedation score at each time point within 24 hours after extubation in group P was not significantly different from the same time point in group C. The MC of 24 hours after operation in group P was (4.5±2.3) mg, which was less than that of group C (9.2±4.9) mg (P<0.001). The level “very satisfied” accounted for 80% and 23.6% in Group P and Group C respectively. Conclusion For patients undergoing PCNL, ThPVB is effective in decreasing postoperative pain and can improve the postoperative satisfaction for patients.
