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          Paravertebral Block improves Pain Control for Percutaneous Nephrolithotomy

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          Percutaneous nephrolithotomyis a minimally invasive procedure, but there is pain that typically follows. A new study states the use of a paravertebral block could be an effective strategy for pain reduction in patients undergoing this procedure.

          The finding was from the first RCT, according to researchers who investigated the use of paravertebral block prior to percutaneous nephrolithotomy. Patients who received the block showed improved pain scores and decreased use of opioids. Patients randomly assigned to paravertebral block also had lower rates of antiemetic use. Although the power analysis called for twice the number of patients, the study was terminated early due to the significant results, say the researchers.

           

          Most noteworthy was that intraoperative opioid use, postoperative opioid use, frequency of opioid use and antiemetic use were significantly lower in the paravertebral block group as compared to the control group. This means paravertebral block is very effective means of pain control for patients undergoing percutaneous nephrolithotomy.

          The 45 patients enrolled in the study had no complications attributed to the paravertebral block. Although average visual analog scale (VAS) pain scores were similar over the first 24 hours, the paravertebral group experienced statistically significantly less pain.

          This is what researchers had to say on the early halting of the study. “We had a planned interim analysis, which is why we stopped at 45 patients. After analyzing our data and seeing its significance, we decided not to subject 40 more patients to placebo when paravertebral block had clearly demonstrated superior pain control. Ethically, we decided it was best to stop.”

          Ref: http://www.anesthesiologynews.com/Pain-Medicine/Article/08-17/Paravertebral-Block-Improves-Pain-Control-For-Percutaneous-Nephrolithotomy/42094


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