Effects of Ultrasound-Guided Thoracic Paravertebral Block on Postoperative Pain in Children Undergoing Percutaneous Nephrolithotomy

Özet

Objective: To compare the effects of ultrasound-guided thoracic paravertebral block (PVB) and intravenous paracetamol on postoperative paincontrol in paediatric patients undergoing percutaneous nephrolithotomy (PNL).Methods: Forty patients aged 1-5 years, with an American Society of Anesthesiologists physical status I-II, scheduled for PNL were enrolled intothis prospective randomised controlled trial. After arrival in the operating room, all patients were administered standardised general anaesthesia.Patients in Group PVB received ultrasound-guided PVB using bupivacaine 0.5% at a total volume of 0.5 mL kg-1 at the vertebral levels T11, T12and L1. Patients in Group P were administered paracetamol intravenously (15 mg kg-1) before the beginning of surgery. Patients in both groupswere given tramadol (1 mg kg-1) for supplemental analgesia. Patient demographics, haemodynamic parameters, peripheral oxygen saturationand sevoflurane concentration were recorded. The Face, Legs, Activity, Cry and Consolability pain scores; satisfaction of parents; the number ofpatients requiring supplemental analgesia; and complications were evaluated during the postoperative period.Results: Pain scores were significantly lower in Group PVB compared with Group P (p=0.001). There were no analgesic requirements in GroupPVB; however, all patients needed a supplemental analgesic in Group P. Parental satisfaction was higher in Group PVB than in Group P.Conclusion: This study demonstrated that ultrasound-guided PVB provides more effective postoperative analgesia with no side effects compared to intravenous paracetamol in children undergoing PNL.