Efficacy of Ultrasound Guided Single Level Paravertebral Block vs Transmuscular Quadratus Lumborum Block (III) for Postoperative Analgesia after Percutaneous Nephrolithotomy Surgeries- A Randomised Clinical Study
Published: July 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/62663.18236
Vijetha Devaram, A Shiny Priyadarshini, Kandukuru Krishna Chaithanya, Sukanya Mallela, Chaitanya Gunapati, Prabhavathi Ravipati
1. Associate Professor, Department of Anaesthesiology, Narayana Medical College, Nellore, Andhra Pradesh, India.
2. Assistant Professor, Department of Anaesthesiology, Narayana Medical College, Nellore, Andhra Pradesh, India.
3. Professor, Department of Anaesthesiology, Narayana Medical College, Nellore, Andhra Pradesh, India.
4. Postgraduate, Department of Anaesthesiology, Narayana Medical College, Nellore, Andhra Pradesh, India.
5. Assistant Professor, Department of Anaesthesiology, Narayana Medical College, Nellore, Andhra Pradesh, India.
6. Professor, Department of Anaesthesiology, Narayana Medical College, Nellore, Andhra Pradesh, India.
Correspondence
Sukanya Mallela,
120/1, Baba Nagar, Nellore-524003, Andhra Pradesh, India.
E-mail: surya.sukanya93@gmail.com
Introduction: Pain control forms an essential component of enhanced recovery after surgery. Regional nerve blocks forms the mainstay of pain relief now-a-days. Pain after Percutaneous Nephrolithotomy (PCNL) surgeries is always distressing to the patient due to injury to the renal capsule.
Aim: To compare the efficacy of Ultrasonography (USG) guided Paravertebral Block (PVB) versus Quadratus Lumborum Block (QLB) for postoperative analgesia following PCNL surgeries.
Materials and Methods: This randomised clinical study was done between February 2021 to August 2022 at Narayana Medical College and Hospitals, Nellore, Andhra Pradesh, India. Sixty patients of American Society of Anaesthesiology (ASA) I and II between 30-60 years age group undergoing PCNL surgeries were divided into two groups. Group P received USG guided PVB at T9-T10 level with 20 mL of 0.25% Levobupivacaine with 8 mg Dexamethasone whereas group Q received QLB (III) with 20 mL of 0.25% Levobupivacaine with 8 mg Dexamethasone. Visual Analogue Score (VAS), time for first rescue analgesic and number of patients requiring rescue analgesic in first 24 hours were measured. The unpaired t-test was used to compare continuous variables whereas the Chi-square test was used to compare the categorical variables.
Results: There was no statistical difference in terms of sex, age, weight, height or American Society of Anaesthesiology (ASA) grade (p>0.05). The mean time required for rescue analgesia in group P was around 478 minutes compared to group Q with 346 minutes which was statistically significant (p=0.001). Mean tramadol consumption in group Q was significantly high (155 mg) compared to group P (125 mg). VAS was significantly better in group P.
Conclusion: The USG guided single level PVB provides superior analgesia compared to transmuscular QLB for postoperative analgesia after PCNL surgeries which helps in enhanced recovery after surgery.
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