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Paravertebral Block Versus Epidural Anesthesia for Percutaneous Nephrolithotomy

Not Applicable
Completed
Conditions
Kidney Calculi
Interventions
Procedure: epidural anesthesia
Procedure: paravertebral block
Registration Number
NCT03018899
Lead Sponsor
Huazhong University of Science and Technology
Brief Summary

This prospective, randomized study is aimed to assess the efficacy and safety of paravertebral block compared to epidural anesthesia for percutaneous nephrolithotomy. The investigators suppose that paravertebral block is not inferior in controlling the perioperative pain for percutaneous nephrolithotomy compared to epidural block.

Detailed Description

Background: Percutaneous nephrolithotomy (PCNL) is generally performed under general or neuraxial anesthesia. The investigators have reported three patients who were at high risk of both general anesthesia and neuraxial anesthesia received percutaneous nephrolithotomy with ultrasound guided paravertebral block. Then,The investigators performed ultrasound guided paravertebral block for 45 patients who received percutaneous nephrolithotomy successfully. The investigators' impression is that paravertebral block is as effective as epidural anesthesia for surgical anesthesia of percutaneous nephrolithotomy.

Objectives:To assess the efficacy and safety of paravertebral block compared to epidural anesthesia for surgical anesthesia of percutaneous nephrolithotomy.

Methods: Fifty adult patients undergoing elective percutaneous nephrolithotomy will be randomized to receive ultrasound guided paravertebral block or epidural anesthesia. The primary outcome will be the pain score 12h postoperation. The secondary outcomes will include: time spent to perform block, dose of intraoperative opioids, rate of hypotension need for vasoconstrictors, muscle Power Grading of the lower legs at the end of the operation, anus exhaust time, opioid consumption postoperation, postoperative PONV score and the frequency of vomiting , hospitalization duration and patient satisfaction.

Clinical Implications: Ultrasound guided paravertebral block could be an equally effective and safe alternative to epidural block for surgical anesthesia of percutaneous nephrolithotomy.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
50
Inclusion Criteria
  • American Society of Anesthesiologists physical statusⅠ-Ⅲ
  • Undergo first stage percutaneous nephrolithotomy
  • Informed consent
Exclusion Criteria
  • BMI>35
  • Coagulopathy, on anticoagulants
  • History of surgery on spine
  • Spine deformity
  • A known allergy to the drugs being used
  • Tumor or infection at the site of puncture
  • inability to provide adequate informed consent
  • refusal to participate in the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Epiduralepidural anesthesiapatients received thoracic epidural anesthesia for percutaneous nephrolithotomy
paravertebral blockparavertebral blockpatients received ultrasound guided two-segment paravertebral block for percutaneous nephrolithotomy
Primary Outcome Measures
NameTimeMethod
pain score 12h post operation12 hours postoperation
Secondary Outcome Measures
NameTimeMethod
time spent to perform blockduring block
dose of intraoperative opioidsduring operation
rate of hypotensionduring operation
opioid consumption postoperation12 hours postoperation
postoperative PONV score and the frequency of vomiting24 hours postoperation
Hospitalization duration10 days postoperation
Muscle Power Grading of the lower legs at the end of the operation12 hours postoperation
Patient satisfactionone day before discharge

Patient satisfaction will be evaluated by 5-point Likert scal

Trial Locations

Locations (1)

Tongji Hospital

🇨🇳

Wuhan, Hubei, China

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