Comparision of post-operative analgesic efficacy of Erector spinae plane block with Retrolaminar block in patients undergoing Percutaneous Nephrolithotomy

This prospective randomized study will compare the postoperative analgesic efficacy of ultrasound-guided erector spinae plane block and retrolaminar block in 80 ASA I–II patients aged 18–65 years undergoing percutaneous nephrolithotomy (PCNL), a procedure associated with significant postoperative pain. While opioids and epidural analgesia are effective, their adverse effects limit routine use, and newer interfascial plane blocks such as erector spinae plane block and retrolaminar block offer safer alternatives, though direct comparative evidence is scarce. Patients will be randomized to receive either erector spinae plane block or retrolaminar block with 20 mL of 0.25% bupivacaine under ultrasound guidance. The primary outcome will be analgesic efficacy, assessed by Visual Analogue Scale (VAS) scores at rest and deep breathing at 1, 4, 8, and 24 hours postoperatively. Secondary outcomes include intraoperative fentanyl consumption, time to first rescue analgesia, total tramadol requirement in 24 hours, postoperative nausea and vomiting, block-related complications, and patient satisfaction using the Likert scale. The study aims to establish whether retrolaminar block provides analgesia comparable to erector spinae plane block with a favorable safety profile, thereby guiding optimal pain management strategies in PCNL.