Erector spinae plane block with catheter for management of percutaneous nephrolithotomy: A three case report.
Medicine (Baltimore)
; 99(40): e22477, 2020 Oct 02.
Article
en En
| MEDLINE
| ID: mdl-33019439
ABSTRACT
INTRODUCTION:
Percutaneous nephrolithotomy is a procedure used for management of refractory renal calculi. Oral and parenteral opioids, along with local anesthetic infiltration, neuraxial anesthesia, and paravertebral blocks are the most common methods of managing intra-operative and post-operative pain for these patients. The erector spinae plane block with catheter (ESPC) is a newer interfascial regional anesthetic technique that can be used to manage peri-operative pain in these patients. CLINICALFINDINGS:
Three patients complained of significant flank pain were scheduled for percutaneous nephrolithotomy under general anesthesia in the prone position. DIAGNOSES Patients were diagnosed with large renal calculi. THERAPEUTICINTERVENTIONS:
Patients received ESPC in the pre-operative holding area at the level of the T7 transverse process. The ESPCS were bolused with a solution of 30âmL 0.25% bupivacaine with 4âmg dexamethasone prior to surgery. Patients also received oral tramadol 50âmg and acetaminophen 1âg as part of the multimodal pain protocol prior to surgery. After the procedure, the patients were bolused with 0.25% bupivacaine or started on an infusion of 0.25% bupivacaine to manage their pain.OUTCOMES:
No opioid or other pain medications, other than the local anesthetic solution given in the ESPCs, were used during the intra-operative or post-operative period for management of pain in these patients. Visual analogue scale (VAS) scores were below 4 for all patients in the post-operative period, and patients did not report any issues with post-operative nausea or vomiting.CONCLUSION:
These patients were compared to 3 prior patients who had undergone percutaneous nephrolithotomy without ESPC. The 3 patients without ESPC placement reported increased VAS scores, had increased opioid/pain medication consumption intraoperatively and postoperatively, and had increased incidence of perioperative nausea when compared to our ESPC patients. Our report shows that ESPC, in combination with a multimodal pain protocol, can be a good option for management of patients undergoing percutaneous nephrolithotomy.
Texto completo:
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Banco de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
/
Cálculos Renales
/
Nefrolitotomía Percutánea
/
Bloqueo Nervioso
Tipo de estudio:
Guideline
Límite:
Aged
/
Female
/
Humans
/
Middle aged
Idioma:
En
Año:
2020
Tipo del documento:
Article